NPIMap

Individual provider Active NPI

Marian Megelly, D.M.D

  • Dentist
  • Kailua Kona, HI
National Provider Identifier
1811447626
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DT 2676 Issued in HI
Practice address
75-1028 Henry St
#102
Kailua Kona, HI 96740-1693
Phone
(808) 329-0025
NPI assigned
Oct 5, 2016
Last updated
Oct 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DT 2676 HI Primary

Addresses

Primary practice location

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

Mailing address

500 Ala Moana Blvd
Suite 7-220
Honolulu, HI 96813-4920

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

LicenseStateTypeSpecialty
DT 2676HIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Vine Dental PLLC CurrentSince Dec 31, 2023 Accepting new patients
Hawaii Dental Group, Inc. Past Accepting new patients

Locations

481 Bedford St
Abington, MA 02351
Phone (781) 423-2543

Organizations & group practices 2

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": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1811447626",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-1028 HENRY ST",
            "address_2": "#102",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401693",
            "telephone_number": "808-329-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEGELLY",
        "first_name": "MARIAN",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT 2676",
            "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 Oct 5, 2016; 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.