Healthcare Provider Details

I. General information

NPI: 1992997282
Provider Name (Legal Business Name): JASMIN DE GUZMAN D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 CLARK ROAD BLDG 339
FORT SHAFTER HI
96858
US

IV. Provider business mailing address

344 HEARD STREET BLDG 556
SCHOFIELD BARRACKS HI
96857
US

V. Phone/Fax

Practice location:
  • Phone: 808-438-5555
  • Fax:
Mailing address:
  • Phone: 808-438-5576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS037235
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS037235
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: