Provider Demographics
NPI:1790936763
Name:ASPIAZU, JUSTYNA KATHERINE (DDS)
Entity Type:Individual
Prefix:
First Name:JUSTYNA
Middle Name:KATHERINE
Last Name:ASPIAZU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 UNION MALL STE 502
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2711
Mailing Address - Country:US
Mailing Address - Phone:808-536-3405
Mailing Address - Fax:808-523-2923
Practice Address - Street 1:1136 UNION MALL STE 502
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2711
Practice Address - Country:US
Practice Address - Phone:808-536-3405
Practice Address - Fax:808-523-2923
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI23941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025205100Medicaid