Jaurequi, Randall P

Jaurequi, Randall P is an sole proprietor health care provider with primary practice located at 4370 Kukui Grove St Suite 211, Lihue HI 96766-2001. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Jaurequi, Randall P can be contacted via phone (808) 245-8866.

Contact Information

Primary practice address
4370 Kukui Grove St Suite 211 Lihue HI 96766-2001
Fax: (808) 246-0698
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2009 Hawaii

Profile Details

NPI number 1275694655
LBN Legal business name Jaurequi, Randall P
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 12th, 2006
Last updated Aug 1st, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275694655 NPPES
Hawaii MEDICAID 50514101

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