Provider Demographics
NPI:1639101454
Name:AZUMA, EUGENE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:M
Last Name:AZUMA
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 1:1060 YOUNG ST STE 220
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1609
Mailing Address - Country:US
Mailing Address - Phone:808-528-2221
Mailing Address - Fax:808-528-1116
Practice Address - Street 1:1060 YOUNG ST STE 220
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1609
Practice Address - Country:US
Practice Address - Phone:808-528-2221
Practice Address - Fax:808-528-1116
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-16581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIDT-1658OtherHAWAII DENTAL LICENSE NUM
HIA-8078-6OtherHMSA PROVIDER NUMBER
HIA-8078-6OtherHMSA PROVIDER NUMBER