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General NPI Number Information
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NPI Number | 1235948076
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Entity Type | Individual
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Provider Name | KATHRYN TERUYA DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 9067 POPLAR AVE STE 113
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City | GERMANTOWN
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State | TN
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Zip | 38138-7851
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Country | US
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Telephone | 901-723-2103
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Fax |
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Provider Business Mailing Address
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Address Line | 905 ONAHA ST
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City | HONOLULU
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State | HI
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Zip | 96816-5107
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Country | US
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Telephone | 808-927-5048
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 12698
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License Number State | TN
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