Individual provider Active NPI

William Robert Sicilia, DMD

  • General Practice Dentistry
  • Honolulu, HI
National Provider Identifier
1669829099
Registry record updated Dec 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DT-2653 Issued in HI
Practice address
1314 S King St Ste 510
Honolulu, HI 96814-1940
Phone
(808) 593-8476
NPI assigned
May 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2023

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 DT-2653 HI Primary

Addresses

Primary practice location

1314 S King St Ste 510
Honolulu, HI 96814-1940

Mailing address

1314 S King St Ste 510
Honolulu, HI 96814-1940
Phone (808) 748-4974

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
I20161026001835 HI Order and Referring Only - DentistPractitioner - Dentist 1456639475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT-2653HIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sicilia Dental LLC General Practice CurrentSince Dec 10, 2023 Accepting new patients

Locations

1314 S King St
Ste 510
Honolulu, HI 96814
Phone (808) 593-8476

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702080000000",
    "number": "1669829099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 S KING ST STE 510",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141940",
            "telephone_number": "808-748-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 S KING ST STE 510",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141940",
            "telephone_number": "808-593-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICILIA",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-16",
        "last_updated": "2023-12-09",
        "certification_date": "2023-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT-2653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.