NPIMap

Organization Active NPI

Derek B Tom DDS LLC

  • Pediatric Dentistry
  • Aiea, HI
National Provider Identifier
1669826244
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DT-2008 Issued in HI
Legal business name
DEREK B TOM DDS LLC
Practice address
98-150 Kaonohi St
C207
Aiea, HI 96701-5047
Phone
(808) 488-0100
Fax
(808) 488-0110
NPI assigned
Apr 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Authorized official

Name
Dr. Derek B Tom, D.D.S.
Title
Owner
Phone
(808) 488-0100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DT-2008 HI Primary

Addresses

Primary practice location

98-150 Kaonohi St
C207
Aiea, HI 96701-5047

Mailing address

98-150 Kaonohi St
C207
Aiea, HI 96701-5047
Phone (808) 488-0100

National Provider Directory

National Provider Directory
Tax ID family
Aiea Pediatric Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

98-150 Kaonohi St
Ste C207
Aiea, HI 96701
Phone (808) 488-0100

NPI Registry JSON

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1669826244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98-150 KAONOHI ST",
            "address_2": "C207",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015047",
            "telephone_number": "808-488-0100",
            "fax_number": "808-488-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98-150 KAONOHI ST",
            "address_2": "C207",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967015047",
            "telephone_number": "808-488-0100",
            "fax_number": "808-488-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK B TOM DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "TOM",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-488-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "HI",
            "license": "DT-2008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; 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.