Individual provider Active NPI

Donna Dennerlein

  • Clinical Social Worker
  • Kailua Kona, HI
National Provider Identifier
1720475312
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
65911 Issued in CA
Practice address
74-381 Kealakehe Pkwy
Suite F
Kailua Kona, HI 96740-2705
Phone
(209) 261-0166
NPI assigned
Apr 21, 2015
Last updated
Apr 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3695 HI
Clinical Social Worker 1041C0700X 65911 CA Primary

Addresses

Primary practice location

74-381 Kealakehe Pkwy
Suite F
Kailua Kona, HI 96740-2705

Mailing address

74-381 Kealakehe Pkwy
Suite F
Kailua Kona, HI 96740-2705
Phone (209) 261-0166

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
3695HIMDClinical Social Worker
65911CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Randall H. Hirata M.D., Inc. PastSince Jul 24, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1720475312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74-381 KEALAKEHE PKWY",
            "address_2": "SUITE F",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402705",
            "telephone_number": "209-261-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74-381 KEALAKEHE PKWY",
            "address_2": "SUITE F",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402705",
            "telephone_number": "209-261-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNERLEIN",
        "first_name": "DONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-21",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "3695",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "65911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 6, 2017; 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.