Healthcare Provider Details

I. General information

NPI: 1457643256
Provider Name (Legal Business Name): TAMARA CHRISTINE BEXTON D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 MAKAWAO AVE SUITE 101
MAKAWAO HI
96768-8895
US

IV. Provider business mailing address

PO BOX 790829
PAIA HI
96779-0829
US

V. Phone/Fax

Practice location:
  • Phone: 808-572-9461
  • Fax: 808-572-8323
Mailing address:
  • Phone: 808-283-5456
  • Fax: 808-873-8097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2428
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: