Provider Demographics
NPI:1982298873
Name:MAUI PEDIATRIC DENTISTRY
Entity type:Organization
Organization Name:MAUI PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANKS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-757-5259
Mailing Address - Street 1:1254 S KIHEI RD UNIT 2181
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-4089
Mailing Address - Country:US
Mailing Address - Phone:808-757-5259
Mailing Address - Fax:
Practice Address - Street 1:1280 S KIHEI RD APT 206
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-5296
Practice Address - Country:US
Practice Address - Phone:808-757-5259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty