Provider Demographics
NPI:1447035027
Name:TREVOR HARTWELL DDS LLC
Entity type:Organization
Organization Name:TREVOR HARTWELL DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARTWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-443-2636
Mailing Address - Street 1:64-5191 KINOHOU ST
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-7392
Mailing Address - Country:US
Mailing Address - Phone:808-443-2636
Mailing Address - Fax:808-769-5023
Practice Address - Street 1:64-5191 KINOHOU ST
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-7392
Practice Address - Country:US
Practice Address - Phone:808-443-2636
Practice Address - Fax:808-769-5023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty