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NPI Code Detail

MEDICARE: JENNIFER H. HIROTA, DDS, LLC

MEDICARE: JENNIFER H. HIROTA, DDS, LLC
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
1261QD0000XDental Clinic/CenterDT 2152HI

General Provider Information

NPI Number : 1093892234
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNIFER H. HIROTA, DDS, LLC
Provider Business Mailing Address
First Line : 91-902 FORT WEAVER RD STE 208
Second Line :
City : EWA BEACH
State : HI
Zip : 96706-2261
Country : US
Telephone Number : 808-689-7964
Fax Number : 808-689-0909
Provider Business Practice Location Address
First Line : 91-902 FORT WEAVER RD STE 208
Second Line :
City : EWA BEACH
State : HI
Zip : 96706-2261
Country : US
Telephone Number : 808-689-7964
Fax Number : 808-689-0909
Authorized Official
Title or Position : OWNER
Name : DR. JENNIFER HIROTA
Credential : DDS
Telephone Number : 808-689-7964
Provider Enumeration Date : 11/01/2006
Last Update Date : 08/22/2020

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