Provider Demographics
NPI:1184630659
Name:TERUYA, DARRELL TADAYOSHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:TADAYOSHI
Last Name:TERUYA
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 1:2615 S KING ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-3276
Mailing Address - Country:US
Mailing Address - Phone:808-949-1325
Mailing Address - Fax:
Practice Address - Street 1:2615 S KING ST STE 201
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-3276
Practice Address - Country:US
Practice Address - Phone:808-949-1325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-13211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice