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General NPI Number Information
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NPI Number | 1730318270
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Entity Type | Organization
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Legal Business Name | HAWAII ENDODONTICS LLC
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 30 AULIKE ST SUITE 404
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City | HONOLULU
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State | HI
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Zip | 96734
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Country | US
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Telephone | 808-235-3131
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Fax | 808-234-0127
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Provider Business Mailing Address
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Address Line | 30 AULIKE ST SUITE 404
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City | HONOLULU
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State | HI
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Zip | 96734
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Country | US
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Telephone | 808-235-3131
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Fax | 808-234-0127
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Authorized Official
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Title or Position | SENIOR CREDENTIALING TEAM LEAD
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Name | JENNY GARCIA-ROCHA
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Credential |
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Telephone | 972-869-3789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 2093
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License Number State | HI
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