1. Home
  2. Directory
  3. Hawaii
  4. Kailua
  5. Dentist
  6. NPI Profile

ENCHANTED LAKE DENTAL LLC
NPI 1588355267
Dentist in Kailua, HI

Active since May 15, 2023
1058 KEOLU DR STE B104, KAILUA, HI 96734(808) 261-6767 Get Directions Write a Review

NPPES record last updated: May 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Enchanted Lake Dental Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ENCHANTED LAKE DENTAL LLC (NPI 1588355267) is a healthcare organization registered as a dentist in Kailua, Hawaii and active in the NPI registry since May 2023. The organization lists Justin Sjulson, Owner, as its authorized official.

NPPES Registry Identity

NPI1588355267
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameENCHANTED LAKE DENTAL LLC
Location Address1058 KEOLU DR STE B104Kailua, HI 96734-3844
Mailing Address1058 Keolu Dr Ste B104Kailua, HI 96734-3844 · (808) 261-6767
Phone(808) 261-6767
Organization SubpartNo
Authorized OfficialJustin SjulsonOwner · (952) 353-0411
Enumeration DateMay 15, 2023
NPPES CertifiedMay 15, 2023
✔ NPI 1588355267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1058 KEOLU DR STE B104, Kailua, HI 96734
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Enchanted Lake Dental LLC's NPI number?

The NPI number for Enchanted Lake Dental LLC is 1588355267. It was assigned to this organization in the NPPES registry on May 15, 2023.

Where is Enchanted Lake Dental LLC located?

Enchanted Lake Dental LLC is located at 1058 Keolu Dr Ste B104, Kailua, HI 96734. The listed phone number is (808) 261-6767.

What is Enchanted Lake Dental LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Enchanted Lake Dental LLC was last updated on May 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.