Healthcare Provider Details

I. General information

NPI: 1962382150
Provider Name (Legal Business Name): KRISTIN ROCHELLE FLORES RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2025
Last Update Date: 09/06/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 WAIALAE AVE STE 202
HONOLULU HI
96816-5312
US

IV. Provider business mailing address

1942 LUSITANA ST
HONOLULU HI
96813-1532
US

V. Phone/Fax

Practice location:
  • Phone: 808-554-5248
  • Fax:
Mailing address:
  • Phone: 808-554-5248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number30673
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2197
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: