Hawaii Dental Group, Inc.

NPI #1497063226 in Hilo, Hawaii

Provider Information

NPI Number: 1497063226
Entity Type: Organization
Organization Name: Hawaii Dental Group, Inc.
Subpart: Yes (part of a larger organization)
Parent Organization: HAWAII DENTAL GROUP, INC.
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 14, 2010
Last Updated: Sep 14, 2010

Practice Location

Address: 400 HUALANI ST
Address 2: BLDG. 9, SUITE 192
City: Hilo
State: Hawaii
ZIP Code: 96720-4378
Phone: (808) 935-6620

Authorized Official

Name: DR. GARY KONDO
Title: CHIEF EXECUTIVE OFFICER
Phone: (808) 523-3103

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Endodontics — Endodontics	1223E0200X
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X
Dentist - Periodontics — Periodontics	1223P0300X
Dentist - Prosthodontics — Prosthodontics	1223P0700X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X
Dental Hygienist	124Q00000X
Dental Assistant	126800000X
Dentist - General Practice — General Practice	1223G0001X	Primary

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