Provider Demographics
NPI:1528391182
Name:WARDWELL, SCOTT ASHLEY (D D S)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ASHLEY
Last Name:WARDWELL
Suffix:
Gender:M
Credentials:D D S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 S KING ST STE 601
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1952
Mailing Address - Country:US
Mailing Address - Phone:808-946-0713
Mailing Address - Fax:808-942-2661
Practice Address - Street 1:1150 S KING ST STE 601
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1952
Practice Address - Country:US
Practice Address - Phone:808-946-0713
Practice Address - Fax:808-942-2661
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS389421223G0001X
HIDT18481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
A58238OtherBLUE CROSS BLUE SHIELD
91848OtherGEHA
91848OtherCIGNA
91848OtherUSA DELTA
91848OtherGUARDIAN
793732OtherUNITED CONCORDIA
HI91848OtherHAWAII DENTAL SERVICE
HIA58238OtherHAWAII MEDICAL SERVICE ASSOC
91848OtherUNITED HEALTHCARE
91848OtherMETLIFE
HI91848OtherHMAA
91848OtherAETNA