Provider Demographics
NPI:1932111077
Name:GEYER, LILLY LI (DMD)
Entity Type:Individual
Prefix:DR
First Name:LILLY
Middle Name:LI
Last Name:GEYER
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 1:94-1022 MAIAU ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-5506
Mailing Address - Country:US
Mailing Address - Phone:808-384-4579
Mailing Address - Fax:808-261-1449
Practice Address - Street 1:30 AULIKE ST
Practice Address - Street 2:SUITE 503
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2707
Practice Address - Country:US
Practice Address - Phone:808-384-4579
Practice Address - Fax:808-261-1449
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT21061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice