Provider Demographics
NPI:1497391247
Name:MELLO, HELENA S (DMD)
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:S
Last Name:MELLO
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 1:275 W KAAHUMANU AVE STE 188
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-1674
Mailing Address - Country:US
Mailing Address - Phone:808-856-4640
Mailing Address - Fax:
Practice Address - Street 1:275 W KAAHUMANU AVE STE 188
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1674
Practice Address - Country:US
Practice Address - Phone:808-856-4640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT2837122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist