Provider Demographics
NPI:1093237695
Name:WAIPA, CAYCE KELIIKAI (RDH)
Entity Type:Individual
Prefix:
First Name:CAYCE
Middle Name:KELIIKAI
Last Name:WAIPA
Suffix:
Gender:M
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86-260 FARRINGTON HIGHWAY WAIANAE
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:86-260 FARRINGTON HIGHWAY
Practice Address - Street 2:MAIN HEALTH CENTER
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792
Practice Address - Country:US
Practice Address - Phone:808-697-3496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDH2077124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist