Provider Demographics
NPI:1699818302
Name:CHANG-MOTOOKA, TAMMY ML (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:ML
Last Name:CHANG-MOTOOKA
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1441 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 520
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4402
Mailing Address - Country:US
Mailing Address - Phone:808-947-3737
Mailing Address - Fax:808-947-3544
Practice Address - Street 1:1441 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 520
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4402
Practice Address - Country:US
Practice Address - Phone:808-947-3737
Practice Address - Fax:808-947-3544
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI17811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics