Individual provider Active NPI

Jerald Satoru Takesono, D.D.S.

  • General Practice Dentistry
  • Kaneohe, HI
National Provider Identifier
1649287020
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
HAWAII866 Issued in HI
Practice address
45-939 Kamehameha Hwy
Suite 201
Kaneohe, HI 96744-3221
Phone
(808) 235-7500
Fax
(808) 235-5095
NPI assigned
Aug 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 HAWAII866 HI Primary

Addresses

Primary practice location

45-939 Kamehameha Hwy
Suite 201
Kaneohe, HI 96744-3221

Mailing address

45-939 Kamehameha Highway
Suite 201
Kaneohe, HI 96744
Phone (808) 235-7500

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
HAWAII866HIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649287020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45-939 KAMEHAMEHA HIGHWAY",
            "address_2": "SUITE 201",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "96744",
            "telephone_number": "808-235-7500",
            "fax_number": "808-235-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45-939 KAMEHAMEHA HWY",
            "address_2": "SUITE 201",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967443221",
            "telephone_number": "808-235-7500",
            "fax_number": "808-235-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKESONO",
        "first_name": "JERALD",
        "middle_name": "SATORU",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "HAWAII866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaneohe, HI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.