Provider Demographics
NPI:1518478825
Name:PURE SMILES HAWAII, LLC
Entity Type:Organization
Organization Name:PURE SMILES HAWAII, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHYONG-YING
Authorized Official - Middle Name:WHANG
Authorized Official - Last Name:SHIRAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-735-3455
Mailing Address - Street 1:4211 WAIALAE AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5318
Mailing Address - Country:US
Mailing Address - Phone:808-735-3455
Mailing Address - Fax:
Practice Address - Street 1:4211 WAIALAE AVE STE 501
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5318
Practice Address - Country:US
Practice Address - Phone:808-735-3455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT2305261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental