MEDICARE: DR. JACQUELINE S BROWN-HITOMI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1894	HI

General Provider Information

NPI Number	:	1013924539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELINE S BROWN-HITOMI DDS

Provider Business Mailing Address
First Line	:	1600 KAPIOLANI BLVD
Second Line	:	SUITE 518
City	:	HONOLULU
State	:	HI
Zip	:	96814-3801
Country	:	US
Telephone Number	:	808-949-5644
Fax Number	:	808-949-8852

Provider Business Practice Location Address
First Line	:	1600 KAPIOLANI BLVD
Second Line	:	SUITE 518
City	:	HONOLULU
State	:	HI
Zip	:	96814-3801
Country	:	US
Telephone Number	:	808-949-5644
Fax Number	:	808-949-8852

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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