Provider Demographics
NPI:1255917332
Name:KONA ALOHA DENTAL LLC
Entity type:Organization
Organization Name:KONA ALOHA DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-387-9525
Mailing Address - Street 1:2500 N MCCOLL RD APT 2168
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-0055
Mailing Address - Country:US
Mailing Address - Phone:808-387-9525
Mailing Address - Fax:
Practice Address - Street 1:76-6225 KUAKINI HWY STE B203
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2237
Practice Address - Country:US
Practice Address - Phone:808-329-6167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-20
Last Update Date:2021-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center