Provider Demographics
NPI:1497089114
Name:WONG, ALDRIN BL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALDRIN
Middle Name:BL
Last Name:WONG
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 1:2226 LILIHA ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1600
Mailing Address - Country:US
Mailing Address - Phone:808-538-1190
Mailing Address - Fax:808-538-3843
Practice Address - Street 1:2226 LILIHA ST
Practice Address - Street 2:SUITE 303
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1600
Practice Address - Country:US
Practice Address - Phone:808-538-1190
Practice Address - Fax:808-538-3843
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-18021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice