Healthcare Provider Details

I. General information

NPI: 1790356632
Provider Name (Legal Business Name): A DASH OF NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 S JUDD ST APT 14A
HONOLULU HI
96817-2600
US

IV. Provider business mailing address

615 PIIKOI ST STE 1403
HONOLULU HI
96814-3141
US

V. Phone/Fax

Practice location:
  • Phone: 808-366-8836
  • Fax:
Mailing address:
  • Phone: 808-427-3997
  • Fax: 808-556-0100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DASHEL CORPE
Title or Position: OWNER
Credential:
Phone: 808-366-8836