Healthcare Provider Details

I. General information

NPI: 1972745974
Provider Name (Legal Business Name): JOANNE T. LE DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 04/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 PIIKOI ST SUITE 1404-A
HONOLULU HI
96814-3116
US

IV. Provider business mailing address

615 PIIKOI ST SUITE 1404-A
HONOLULU HI
96814-3116
US

V. Phone/Fax

Practice location:
  • Phone: 808-591-2115
  • Fax: 808-591-2213
Mailing address:
  • Phone: 808-591-2115
  • Fax: 808-591-2213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MRS. TOHA T THAI
Title or Position: RECEIPTIONIST
Credential:
Phone: 808-591-2115