Individual provider Active NPI

Keith Katsuyuki Kuroiwa, DDS

  • General Practice Dentistry
  • Honolulu, HI
National Provider Identifier
1629105572
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DT1340 Issued in HI
Practice address
615 Piikoi St PH 3
PH-3
Honolulu, HI 96814-3138
Phone
(808) 596-2568
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

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 DT1340 HI Primary

Addresses

Primary practice location

615 Piikoi St PH 3
PH-3
Honolulu, HI 96814-3138

Mailing address

615 Piikoi St PH 3
Honolulu, HI 96814-3138
Phone (808) 596-2568

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
I20150710001878 HI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4880906395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT1340HIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629105572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 PIIKOI ST PH 3",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143138",
            "telephone_number": "808-596-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 PIIKOI ST PH 3",
            "address_2": "PH-3",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143138",
            "telephone_number": "808-596-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUROIWA",
        "first_name": "KEITH",
        "middle_name": "KATSUYUKI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT1340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.