NPIMap

Organization Active NPI

Hawaii Dental Group, Inc.

Doing business as Hawaii Family Dental Centers-Kailua-Kona

  • General Practice Dentistry
  • Kailua Kona, HI
National Provider Identifier
1689982407
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HAWAII DENTAL GROUP, INC.
Doing business as
Hawaii Family Dental Centers-Kailua-Kona
Practice address
75-1028 Henry St
Suite 102
Kailua Kona, HI 96740-1693
Phone
(808) 329-0025
Fax
(808) 329-4164
NPI assigned
Sep 14, 2010
Last updated
Sep 14, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
HAWAII DENTAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Authorized official

Name
Dr. Gary Kondo
Title
Chief Executive Officer
Phone
(808) 523-3103

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X NU
General Practice Dentistry 1223G0001X NU Primary
Pediatric Dentistry 1223P0221X NU
Periodontics 1223P0300X NU
Prosthodontics 1223P0700X NU
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU
Dental Hygienist 124Q00000X NU
Dental Assistant 126800000X NU

Addresses

Primary practice location

75-1028 Henry St
Suite 102
Kailua Kona, HI 96740-1693

Mailing address

500 Ala Moana Blvd
Suite 7-220
Honolulu, HI 96813-4920
Phone (808) 523-3103

Other names 1

  • Hawaii Family Dental Centers-Kailua-Kona Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hawaii Dental Group Inc12 organizations share this tax ID, including this one
Part of
Hawaii Dental Group Inc

Other organizations with this tax ID 11

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

Locations

500 Ala Moana Blvd
Ste 7220
Honolulu, HI 96813
Phone (808) 523-3103

75-1028 Henry St
Ste 102
Kailua Kona, HI 96740
Phone (808) 329-0025

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1689982407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD",
            "address_2": "SUITE 7-220",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134920",
            "telephone_number": "808-523-3103",
            "fax_number": "808-523-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-1028 HENRY ST",
            "address_2": "SUITE 102",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401693",
            "telephone_number": "808-329-0025",
            "fax_number": "808-329-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWAII DENTAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAWAII DENTAL GROUP, INC.",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "KONDO",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "808-523-3103",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hawaii Family Dental Centers-Kailua-Kona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.