Individual provider Active NPI

Jochen Madeisky, D.D.S.

  • General Practice Dentistry
  • Kapa'au, HI
National Provider Identifier
1801953542
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D1051 Issued in HI
Practice address
54-3872 Akoni Pule Hwy.
Kapaau, HI 96755
Phone
(808) 889-6277
Fax
(808) 889-0201
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 D1051 HI Primary

Addresses

Primary practice location

54-3872 Akoni Pule Hwy.
Kapaau, HI 96755

Mailing address

PO Box 428
Kapaau, HI 96755-0428
Phone (808) 889-6277

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
I20150629000465 HI Order and Referring Only - DentistPractitioner - Dentist 7113239567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D1051HIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801953542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "KAPAAU",
            "state": "HI",
            "postal_code": "967550428",
            "telephone_number": "808-889-6277",
            "fax_number": "808-889-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54-3872 AKONI PULE HWY.",
            "city": "KAPAAU",
            "state": "HI",
            "postal_code": "96755",
            "telephone_number": "808-889-6277",
            "fax_number": "808-889-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADEISKY",
        "first_name": "JOCHEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "D1051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapa'au, HI

Sources for this page

Verify at the official NPI Registry.