Individual provider Active NPI

Clayton James McElroy

  • Pediatric Dentistry
  • Honolulu, HI
National Provider Identifier
1659954428
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DT-3121-0 Issued in HI
Practice address
1441 Kapiolani Blvd
Honolulu, HI 96814-4402
Phone
(808) 944-1603
NPI assigned
Apr 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DT-3121-0 HI Primary

Addresses

Primary practice location

1441 Kapiolani Blvd
Honolulu, HI 96814-4402

Mailing address

45-616 Pilipaa St
Kaneohe, HI 96744-1882
Phone (618) 402-0991

Other practice location 1

4450 Kapolei Pkwy Ste 570
Kapolei, HI 96707-1898
Phone (808) 774-7827

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT-3121-0HIMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1659954428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45-616 PILIPAA ST",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967441882",
            "telephone_number": "618-402-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 KAPIOLANI BLVD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144402",
            "telephone_number": "808-944-1603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4450 Kapolei Pkwy Ste 570",
            "address_purpose": "LOCATION",
            "city": "Kapolei",
            "state": "HI",
            "postal_code": "967071898",
            "country_code": "US",
            "telephone_number": "808-774-7827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCELROY",
        "first_name": "CLAYTON",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-29",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "HI",
            "license": "DT-3121-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.