Individual provider Active NPI

Jason Y Hiramoto, DDS

  • General Practice Dentistry
  • Honolulu, HI
National Provider Identifier
1568546752
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DT1794 Issued in HI
Practice address
2239 N School St
Honolulu, HI 96819-2539
Phone
(808) 791-9400
Fax
(808) 848-0979
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DT1794 HI Primary

Addresses

Primary practice location

2239 N School St
Honolulu, HI 96819-2539

Mailing address

2239 N School St
Honolulu, HI 96819-2539
Phone (808) 791-9400

Other identifiers 5

IdentifierTypeStateIssuer
00992101MedicaidHI
179401OtherHIHDS
99-0149797OtherHIHMAA
0000201509OtherHIHMSA-PRIVATE
A01030-4OtherHIHMSA-QUES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150728006362 HI Practitioner - Dentist 6204140742 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT1794HIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kokua Kalihi Valley Comprehensive Family Services CurrentSince May 28, 2015 Accepting new patients
Kokua Kalihi Valley Comprehensive Family Services CurrentSince May 28, 2015 Accepting new patients

Locations

2229 N School St
Honolulu, HI 96819
Phone (808) 791-9400

2239 N School St
Honolulu, HI 96819
Phone (808) 791-9400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568546752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 N SCHOOL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968192539",
            "telephone_number": "808-791-9400",
            "fax_number": "808-848-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 N SCHOOL ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968192539",
            "telephone_number": "808-791-9400",
            "fax_number": "808-848-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRAMOTO",
        "first_name": "JASON",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT1794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00992101",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HDS",
            "identifier": "179401",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMAA",
            "identifier": "99-0149797",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA-PRIVATE",
            "identifier": "0000201509",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA-QUES",
            "identifier": "A01030-4",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.