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General NPI Number Information
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NPI Number | 1972829158
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Entity Type | Individual
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Provider Name | LISA KAI KLOSTERMAN D.D.S., M.S.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 934 PUNAHOU ST STE E
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City | HONOLULU
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State | HI
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Zip | 96826-2522
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Country | US
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Telephone | 808-777-2377
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8583
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City | HONOLULU
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State | HI
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Zip | 96830-0583
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Country | US
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Telephone | 808-216-8673
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Fax |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 204195
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 57932
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 30856
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 3150
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License Number State | HI
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