Provider Demographics
NPI:1194013102
Name:HEALTHY HAWAIIAN SMILES,LLC
Entity Type:Organization
Organization Name:HEALTHY HAWAIIAN SMILES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILE
Authorized Official - Middle Name:DALUPAN
Authorized Official - Last Name:SEBASTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-537-2880
Mailing Address - Street 1:1003 BISHOP ST
Mailing Address - Street 2:STE 340
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-6400
Mailing Address - Country:US
Mailing Address - Phone:808-537-2880
Mailing Address - Fax:808-537-1553
Practice Address - Street 1:1003 BISHOP ST
Practice Address - Street 2:STE 340
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-6400
Practice Address - Country:US
Practice Address - Phone:808-537-2880
Practice Address - Fax:808-537-1553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI17061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty