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General NPI Number Information
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NPI Number | 1801953542
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Entity Type | Individual
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Provider Name | JOCHEN MADEISKY D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 54-3872 AKONI PULE HWY.
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City | KAPAAU
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State | HI
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Zip | 96755
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Country | US
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Telephone | 808-889-6277
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Fax | 808-889-0201
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Provider Business Mailing Address
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Address Line | PO BOX 428
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City | KAPAAU
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State | HI
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Zip | 96755-0428
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Country | US
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Telephone | 808-889-6277
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Fax | 808-889-0201
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D1051
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License Number State | HI
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