Provider Demographics
NPI:1114641479
Name:HEATH, ELIZABETH ALOHILANI (RDH)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ALOHILANI
Last Name:HEATH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17789N POLISH TOWN RD
Mailing Address - Street 2:
Mailing Address - City:BARHAMSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23011-2329
Mailing Address - Country:US
Mailing Address - Phone:757-504-6858
Mailing Address - Fax:
Practice Address - Street 1:461 MCLAWS CIR STE 1
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6350
Practice Address - Country:US
Practice Address - Phone:757-221-0249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402208697124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist