Provider Demographics
NPI:1538997192
Name:RAINBOW DENTAL CENTER- EWA BEACH, LLC
Entity type:Organization
Organization Name:RAINBOW DENTAL CENTER- EWA BEACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERRYVEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:808-444-0174
Mailing Address - Street 1:91-3633 KAULUAKOKO ST UNIT 5005
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-5868
Mailing Address - Country:US
Mailing Address - Phone:808-444-0174
Mailing Address - Fax:
Practice Address - Street 1:91-3633 KAULUAKOKO ST UNIT 5005
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-5868
Practice Address - Country:US
Practice Address - Phone:808-444-0174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental