Dr. Ethan Thomas Segerstrom , DDS
Dentist - General Practice β’ Jbphh, HI
480 Central Ave Bldg 1750
Jbphh, HI 968604908
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
Practice Location & Contact Primary Location
480 Central Ave Bldg 1750
Jbphh, HI 968604908
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Dentist - General Practice: NPPES taxonomy is a reported classification, not proof of board certification.
Industry payments (Open Payments)
No Open Payments records are listed for this clinician for 2019β2025.
NPI first issued
2025
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, βDoes your provider accept Medicare as full payment?β
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Compared with the same specialty in Jbphh and Hawaii
6 active clinicians are listed under Dentist - General Practice with a practice address in Jbphh, HI (692 in Hawaii).
Addresses are self-reported to NPPES and may be out of date.
Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo Β· Report an error.
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2026-08-06NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Optometrist
Doctor of Optometry
Internal Medicine
Doctor of Medicine (M.D.)
Nurse Practitioner - Family
Nurse Practitioner
Emergency Medicine
Doctor of Medicine (M.D.)
Internal Medicine - Pulmonary Disease
Doctor of Medicine (M.D.)
Obstetrics & Gynecology - Female Pelvic Medicine and Reconstructive Surgery
Doctor of Medicine (M.D.)
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 480 CENTRAL AVE BLDG 1750, JBPHH, HI 968604908 (Tel: 8886832778)
Registered at 480 CENTRAL AVE, PEARL HARBOR, HI 968604908
NPI status registered as active in NPPES database
Registered at 1721 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 235112802 (Tel: 7579539000)
Registered at 1721 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 235112802 (Tel: 7579539000)
Recorded as ETHAN SEGERSTROM, DDS
Dentist (license number reported to NPPES: IA DDS-10368)
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Mailing Address
480 Central Ave
Pearl Harbor, HI 968604908