| Kalaheo Dental Group | |
|
2-2514 Kaumualii Hwy Suite 204 Kalaheo HI 96741-8303 | |
| (808) 332-9445 | |
| Not Available |
| Full Name | Kalaheo Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 2-2514 Kaumualii Hwy, Kalaheo, Hawaii |
| Authorized Official Name and Position | Michael Dental Group Michael Lutwin (MEMBER) |
| Authorized Official Contact | 8083329445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kalaheo Dental Group 2-2514 Kaumualii Hwy Suite 204 Kalaheo HI 96741-8303 Ph: (808) 332-9445 | Kalaheo Dental Group 2-2514 Kaumualii Hwy Suite 204 Kalaheo HI 96741-8303 Ph: (808) 332-9445 |
| NPI Number | 1104246917 |
|---|---|
| Provider Enumeration Date | 04/18/2014 |
| Last Update Date | 04/18/2014 |
| Medicare PECOS PAC ID | 3577954346 |
|---|---|
| Medicare Enrollment ID | O20220105001646 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104246917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2144 (Hawaii) | Primary |
| Provider Name | Michael Andrew Lutwin |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1255484473 PECOS PAC ID: 4486045259 Enrollment ID: I20220105001843 |
| Provider Name | Kelliann A Rita |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1457662397 PECOS PAC ID: 7315250891 Enrollment ID: I20220309000610 |
Scott S. Shimabukuro, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2-2389 Kaumualii Hwy, Kalaheo, HI 96741 Phone: 808-332-7088 Fax: 808-332-7045 | |
Terry R. Allen Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2-2514 Kaumualii Hwy Ste 204, Kalaheo, HI 96741 Phone: 808-332-9445 Fax: 808-332-9632 | |
Shimabukuro Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2-2389 Kaumualii Highway, Kalaheo, HI 96741 Phone: 808-332-7088 |