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General NPI Number Information
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NPI Number | 1982388088
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Entity Type | Individual
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Provider Name | LEINA NORIKO MIZUSAWA DDS
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Gender | Female
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Dates
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Enumeration Date | 06/09/2023
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 94-779 FARRINGTON HWY STE 301
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City | WAIPAHU
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State | HI
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Zip | 96797-3175
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Country | US
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Telephone | 808-671-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 99-103 PAMOHO PL
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City | AIEA
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State | HI
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Zip | 96701-4125
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Country | US
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Telephone | 808-754-1159
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3243
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License Number State | HI
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