Organization
CEDRIC T LEWIS, DMD, LLC
Active
Other names
Waialae Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CEDRIC T LEWIS DMD (SOLE MEMBER/OWNER)
(808) 732-4377
Entity
Organization
Contact information
Practice address
4211 WAIALAE AVE, SUITE 501, HONOLULU, HI 96816-5306
(808) 732-4377
(808) 732-4158
Mailing address
4211 WAIALAE AVE, SUITE 501, HONOLULU, HI 96816-5306
(808) 732-4377
(808) 732-4158
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT1943
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01460794
TRICARE DENTAL PLAN
HI
01
—
194302
HDS
HI
01
—
222778
HMSA
HI
01
—
DT1943
DENTAL LICENSE
HI
Enumeration date
10/25/2006
Last updated
08/04/2008
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