Healthcare Provider Details

I. General information

NPI: 1295076206
Provider Name (Legal Business Name): HWA PEN HANS HSU DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3-3359 KUHIO HWY
LIHUE HI
96766-1061
US

IV. Provider business mailing address

1045 KAMEHAME DR
HONOLULU HI
96825-2860
US

V. Phone/Fax

Practice location:
  • Phone: 808-378-4869
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDT-3048
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: