Active NPI
Stephanie Boal
- Dental Hygienist
- Waianae, HI
National Provider Identifier
1710386115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 8
- Practice address
- 86-260 Farrington Hwy
Waianae, HI 96792-3128 - Phone
- (808) 697-3496
- Fax
- (808) 697-8020
- NPI assigned
- Aug 21, 2014
- Last updated
- Aug 21, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2009017104 | MO | |
| Dental Hygienist | 124Q00000X | 8 | MO | Primary |
Addresses
Primary practice location
86-260 Farrington Hwy
Waianae, HI 96792-3128
Mailing address
87-931 Kulakoa St
Waianae, HI 96792-3307
Phone (515) 473-5065
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2009017104 | MO | MD | Dental Hygienist |
| 8 | MO | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408579200000",
"number": "1710386115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87-931 KULAKOA ST",
"city": "WAIANAE",
"state": "HI",
"postal_code": "967923307",
"telephone_number": "515-473-5065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "86-260 FARRINGTON HWY",
"city": "WAIANAE",
"state": "HI",
"postal_code": "967923128",
"telephone_number": "808-697-3496",
"fax_number": "808-697-8020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOAL",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-21",
"last_updated": "2014-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MO",
"license": "2009017104",
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MO",
"license": "8",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waianae, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.