Healthcare Provider Details

I. General information

NPI: 1548183114
Provider Name (Legal Business Name): ANNA MARIE LIZAMA RDH, BSDH, RF, OMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

6090 LOKOMAIKAI PL
KAPAA HI
96746-9716
US

IV. Provider business mailing address

6090 LOKOMAIKAI PL
KAPAA HI
96746-9716
US

V. Phone/Fax

Practice location:
  • Phone: 808-651-1071
  • Fax:
Mailing address:
  • Phone: 808-651-1071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number1496
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: