Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1649162017 Individual Practitioner Male Practitioner

Dr. Ethan Thomas Segerstrom , DDS

Dentist - General Practice • Jbphh, HI

Professional Overview & Biography Verified Profile Summary

Dr. Ethan Segerstrom, DDS is a registered healthcare professional specializing in Dentist - General Practice in Jbphh, HI. Practice services are available at 480 CENTRAL AVE BLDG 1750 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

480 Central Ave Bldg 1750

Jbphh, HI 968604908

Telephone 8886832778
Associated Practice Facility / Clinic
🏢 U.s. Navy Facility NPI 1932182052

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Jbphh, HI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.3 Yrs
Regional Practice Density
6 Specialists

Practicing in Jbphh, HI (740 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-08-06
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IA DDS-10368

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Jennifer Griesel , MD

Obstetrics & Gynecology

NPI 1003293754

Doctor of Medicine (M.D.)

Dr. Nicholas Maher , DO

General Practice

NPI 1003655325

Doctor of Osteopathic Medicine (D.O.)

Dr. Edward Daly , MD

Radiology - Body Imaging

NPI 1013025170

Doctor of Medicine (M.D.)

Logan Fitzpatrick

Obstetrics & Gynecology

NPI 1013604974
NPI 1013699875

Doctor of Dental Surgery

Dr. Joshua Monsivais , DO

Student in an Organized Health Care Education/Training Program

NPI 1013708288

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location August 06, 2026

Registered at 480 CENTRAL AVE BLDG 1750, JBPHH, HI 968604908 (Tel: 8886832778)

📍
Updated Business Mailing Address August 06, 2026

Registered at 480 CENTRAL AVE, PEARL HARBOR, HI 968604908

NPI Profile Active July 18, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location July 18, 2025

Registered at 1721 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 235112802 (Tel: 7579539000)

📍
Updated Business Mailing Address July 18, 2025

Registered at 1721 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 235112802 (Tel: 7579539000)

👤
Provider Name / Credentials Updated July 18, 2025

Recorded as ETHAN SEGERSTROM, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 18, 2025

Dentist (License #DDS-10368 in IA)

🟢
Initial NPI Registration & Enumeration July 18, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1649162017
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 18, 2025
Last Update: August 06, 2026
Sole Proprietor: No

Mailing Address

480 Central Ave

Pearl Harbor, HI 968604908

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.