Provider Demographics
NPI:1326322272
Name:CHUAH, IVAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:IVAN
Middle Name:
Last Name:CHUAH
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:PO BOX 30869
Mailing Address - Street 2:
Mailing Address - City:ANAHOLA
Mailing Address - State:HI
Mailing Address - Zip Code:96703-0869
Mailing Address - Country:US
Mailing Address - Phone:808-635-8668
Mailing Address - Fax:
Practice Address - Street 1:4473 PAHEE ST STE K
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-2037
Practice Address - Country:US
Practice Address - Phone:808-821-8898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-2458122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist