Provider Demographics
NPI:1023387073
Name:REGALA & SU, DDS, LLC
Entity Type:Organization
Organization Name:REGALA & SU, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ARLEEN
Authorized Official - Middle Name:GA
Authorized Official - Last Name:REGALA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-488-1900
Mailing Address - Street 1:99-128 AIEA HEIGHTS DR STE 602
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3939
Mailing Address - Country:US
Mailing Address - Phone:808-488-1900
Mailing Address - Fax:808-487-8998
Practice Address - Street 1:99-128 AIEA HEIGHTS DR STE 602
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3939
Practice Address - Country:US
Practice Address - Phone:808-488-1900
Practice Address - Fax:808-487-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI19501223G0001X
HI19211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI50573701Medicaid