Provider Demographics
NPI:1326233289
Name:CHIU, TABITHA (DMD)
Entity Type:Individual
Prefix:DR
First Name:TABITHA
Middle Name:
Last Name:CHIU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 YOUNG ST APT 1005
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1854
Mailing Address - Country:US
Mailing Address - Phone:808-343-9190
Mailing Address - Fax:
Practice Address - Street 1:94-615 KUPUOHI ST STE 206
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-5329
Practice Address - Country:US
Practice Address - Phone:808-288-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI22491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice