Provider Demographics
NPI:1265584775
Name:HOOK, BRADLEY KENT (DDS MS)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:KENT
Last Name:HOOK
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:315 ULUNIU STREET
Mailing Address - Street 2:SUITE 209
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 ULUNIU STREET
Practice Address - Street 2:SUITE 209
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734
Practice Address - Country:US
Practice Address - Phone:808-261-4697
Practice Address - Fax:808-263-7897
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23428-8751223X0400X
HI17601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIB53837401Medicaid