STEPHEN BENJAMIN PETERMAN (NPI# 1104131572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104131572 |
| Entity Type | Individual |
| Full Name | STEPHEN BENJAMIN PETERMAN |
| Credential | D.D.S. |
| Practice Address |
1 Jarrett White Road Bldg 320, Krukowski St Usa Dentac Tripler Amc HI 96859-5000 |
| Practice Telephone | 8084331021 |
| Practice Fax Number | 8084333928 |
| Mailing Telephone | 8084331021 |
| Mailing Fax Number | 8084333928 |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2016-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 6902 | NE | Dental Providers |
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
6902 | NE | Dental Providers |
| Street Address |
1 JARRETT WHITE ROAD BLDG 320, KRUKOWSKI ST USA DENTAC |
| City | TRIPLER AMC |
| State | HI |
| Zip Code | 96859-5000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770115792 | The Janz Corporation | Durable Medical Equipment & Medical Supplies | Tripler Medical Center, C-103, Honolulu, HI 96859 | 2020-02-07 |
| 1467726927 | Elton E Bacon | Orthotist | 1 Jarrett White Rd Dept of The Army, Attn: Orthopedic Brace Clinic (mchk-dso-a), Tripler Amc, HI 96859 | 2012-03-01 |
| 1063738813 | Defense Finance & Actg Service | Military Hospital | 691 Schofield Barracks, U.s Army Health Clinic Bldg, Wahiawa, HI 96859 | 2010-04-19 |
| 1972737153 | Kyong Su Min | Orthopaedic Surgery | 1 Jarrett White Rd Bldg 4f, Tripler Army Medical Center, HI 96859 | 2009-05-04 |
| 1558503854 | Mark Andrew Gerum | Social Worker | Tripler Army Medical Center, 1 Jarrett White Road, Intensive Outpatient Program (iop), Honolulu, HI 96859 | 2009-04-01 |
| 1578720926 | Travis Jaya Mason | Surgery | Tripler Army Medical Center 1 Jarrett White Road, Honolulu, HI 96859 | 2008-05-21 |
| 1467513168 | Joselyn Cabalo Funtanilla Ponce | Registered Nurse | 1 Jarrett White Rd Bldg 4, Tripler Amc, HI 96859 | 2006-12-13 |
| 1346280195 | Harkirtin Kaur Mciver | Pediatrics | Tripler Army Medical Center Mchk-pe, 1 Jarrett White Road, Honolulu, HI 96859 | 2006-06-08 |
| 1043297740 | Jacqueline Seger | Registered Nurse | Tamc 1 Jarrett-white Rd., 1 Jarrett-white Rd. / Mchk-dsc, Honolulu, HI 96859 | 2005-12-23 |
| 1982694683 | Peter Marlin | Psychiatry & Neurology | Tamc, 1 Jarriet White Road, Honolulu, HI 96859 | 2005-10-24 |
| Find all providers in zip 96859 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548351166 | Kelley Lucille Tomsett | Dentist | 1 Jarrett White Rd, Tripler Amc, HI 96859 | 2006-09-27 |
| 1467439604 | Sung Yong Lee | Dentist | 1 Jarrett White Road, Attn: Mcds-nh, Us Army Dental Activity Hawaii, Tripler Amc, HI 96859-5000 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285051847 | Erik Wong | Dentist | 140 Hoohana St Ste 300, Kahului, HI 96732 | 2014-03-20 |
| 1194941385 | Miriam Moria Amjadi | Dentist | 1441 Kapiolani Blvd Ste 706, Honolulu, HI 96814-4404 | 2007-04-17 |
| 1407907512 | Ben T. Kawasaki | Dentist | 321 N Kuakini St Ste 804, Honolulu, HI 96817-2362 | 2007-01-15 |
| 1033219597 | Peter H Fay | Dentist | 140 Hoohana St., #300, Kahului, HI 96732 | 2006-09-25 |
| 1245342948 | Duane Toshio Fujii | Dentist | 1100 Ward Ave Ste 820, Honolulu, HI 96814-1617 | 2006-08-31 |
| 1548246481 | Andrew Scott Alamar | Dentist | 91-1071 Waikai St, Ewa Beach, HI 96706-6458 | 2005-12-22 |
| 1144219411 | Guillermo Enrique Orraca II | Dentist | 15th Aeromedical-dental Squadron, 755 Scott Circle, Hickam Afb, HI 96853-5399 | 2005-10-19 |
| 1952301509 | Eugene Yukito Yamaguma | Dentist | 1885 Main St, Ste. 208, Wailuku, HI 96793-1819 | 2005-07-26 |
| 1457737272 | Wailuku Dentists LLC | Dentist | 1885 Main St, Suite 208, Wailuku, HI 96793 | 2015-08-04 |
| 1487094637 | Hawaii Prosthodontics LLC | Dentist | 1100 Ward Ave Ste 820, Honolulu, HI 96814-1617 | 2013-07-02 |
| Find all providers with the same taxonomy | ||||
| City | TRIPLER AMC |
| Zip Code | 96859 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.