Supriya Koirala, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DTT292 Issued in HI

Practice address

86-260 Farrington Hwy
Waianae, HI 96792-3128

Phone

(808) 697-3496

NPI assigned

Feb 13, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: supriya.koirala.p1@direct.wcchc.nextgenshare.com
• Direct secure messaging: nehring.richardo.p1@direct.wcchc.nextgenshare.com

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1730628587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 ALA MOANA BLVD APT 1909",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151412",
            "telephone_number": "303-503-7818"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631043024",
            "country_code": "US",
            "telephone_number": "314-833-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOIRALA",
        "first_name": "SUPRIYA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "HI",
            "license": "DTT292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eucabeth A Kilonzo, APRN
• Bong Jik Kim, M.D.
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• Cynthia Delores King, RDN, LDN, CDE
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• Jared Yoshiaki Kumasaka Sr., RPH
• Joline L Labbe, FNP, APRN-RX
• Jacqueline Marie Lagman Zajac, FNP-BC
• Kacy Renee Lane, D.D.S.

• Dentist in Waianae, HI
• Providers in Waianae, HI by specialty
• Dentist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.