Healthcare Provider Details

I. General information

NPI: 1013683770
Provider Name (Legal Business Name): HIROSE DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2021
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 KAPIOLANI BLVD STE 1021
HONOLULU HI
96814-3802
US

IV. Provider business mailing address

98-1941 KAAHUMANU ST APT C
AIEA HI
96701-1853
US

V. Phone/Fax

Practice location:
  • Phone: 808-955-3522
  • Fax:
Mailing address:
  • Phone: 808-358-2134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RHINELLE HIROSE
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 808-358-2134