Provider Demographics
NPI:1710391511
Name:SHAIKH, ALYSSA (DDS, MSD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:SHAIKH
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:VIGNERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:930 VALKENBURGH ST SPC 208
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-3914
Mailing Address - Country:US
Mailing Address - Phone:808-261-4696
Mailing Address - Fax:
Practice Address - Street 1:930 VALKENBURGH ST SPC 208
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-3914
Practice Address - Country:US
Practice Address - Phone:808-261-4696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002033331223X0400X
HIDT-28431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty