Provider Demographics
NPI:1114284205
Name:LUM, BRENDT-ALEXANDER J M A (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRENDT-ALEXANDER
Middle Name:J M A
Last Name:LUM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-880 KAMEHAMEHA HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2969
Mailing Address - Country:US
Mailing Address - Phone:808-247-5373
Mailing Address - Fax:808-235-6671
Practice Address - Street 1:45-880 KAMEHAMEHA HWY STE 102
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2969
Practice Address - Country:US
Practice Address - Phone:808-247-5373
Practice Address - Fax:808-235-6671
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-2453122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist