Provider Demographics
NPI:1649614116
Name:DENTAL CARE PROFESSIONALS OF HAWAII, INC.
Entity type:Organization
Organization Name:DENTAL CARE PROFESSIONALS OF HAWAII, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:XIAO-LI SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-536-3405
Mailing Address - Street 1:1136 UNION MALL
Mailing Address - Street 2:SUITE 502
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2719
Mailing Address - Country:US
Mailing Address - Phone:808-536-3405
Mailing Address - Fax:808-523-2923
Practice Address - Street 1:1136 UNION MALL
Practice Address - Street 2:SUITE 502
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2719
Practice Address - Country:US
Practice Address - Phone:808-536-3405
Practice Address - Fax:808-523-2923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty