Randall Scott Cislo, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DT1230 Issued in HI

Practice address

65-1279 Kawaihae Rd
Suite 101
Kamuela, HI 96743-8444

Phone

(808) 885-8617

Fax

(808) 885-9316

NPI assigned

Mar 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 2, 2015 through Sep 2, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Brooks Dental LLC

  dba Randall S Cislo DMD LLC

  • General Practice Dentistry
  • Kamuela, HI
  • NPI 1669268090
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609907245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65-1279 KAWAIHAE RD",
            "address_2": "SUITE 101",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438444",
            "telephone_number": "808-885-8617",
            "fax_number": "808-885-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-1279 KAWAIHAE RD",
            "address_2": "SUITE 101",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438444",
            "telephone_number": "808-885-8617",
            "fax_number": "808-885-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISLO",
        "first_name": "RANDALL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT1230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven J Chelminiak, LCSW
• Cherylin Garvey, M.D., LLC
• Daniel Marcus Chevy, M.D.
• Noel Ming Chia, MD
• Natalie Mun-Yee Chin, MD
• Emily Lee Claspell, EDD
• Emilou Grace Clavero
• Clearview Counseling LLC
• Monique K Cobb-Adams, LMT
• Sandra Ann Coffee, LMT

• General Practice Dentistry in Kamuela, HI
• Providers in Kamuela, HI by specialty
• General Practice Dentistry in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.