Individual provider Active NPI

Dennis Paul Itoga

  • Clinical Psychologist
  • Kapolei, HI
National Provider Identifier
1619453180
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY1716 Issued in HI
Practice address
550 Kunehi St Apt 205
Kapolei, HI 96707-2069
Phone
(808) 674-6641
Fax
(808) 504-5442
NPI assigned
Jul 17, 2018
Last updated
Jul 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY1716 HI Primary

Addresses

Primary practice location

550 Kunehi St Apt 205
Kapolei, HI 96707-2069

Mailing address

888 Kapiolani Blvd Apt 2908
Honolulu, HI 96813-6045
Phone (808) 352-7911

Other identifiers 1

IdentifierTypeStateIssuer
26-4490603MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY1716HIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis Paul Itoga, Psy.D., M.Ed., LLC Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1619453180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 KAPIOLANI BLVD APT 2908",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968136045",
            "telephone_number": "808-352-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 KUNEHI ST APT 205",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072069",
            "telephone_number": "808-674-6641",
            "fax_number": "808-504-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITOGA",
        "first_name": "DENNIS",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY1716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26-4490603",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapolei, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.