Provider Demographics
NPI:1295240968
Name:DENTAL WORLD KAPOLEI, LLC
Entity type:Organization
Organization Name:DENTAL WORLD KAPOLEI, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAEKAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-593-0889
Mailing Address - Street 1:95-720 LANIKUHANA AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-2984
Mailing Address - Country:US
Mailing Address - Phone:808-625-8899
Mailing Address - Fax:
Practice Address - Street 1:590 FARRINGTON HWY UNIT 523
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707
Practice Address - Country:US
Practice Address - Phone:808-674-9988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
1194851949OtherNPI TYPE 1