Provider Demographics
NPI:1245341122
Name:SCHWAB, WENDIE MILLER (DDS)
Entity type:Individual
Prefix:DR
First Name:WENDIE
Middle Name:MILLER
Last Name:SCHWAB
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:PO BOX 2202
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-7202
Mailing Address - Country:US
Mailing Address - Phone:808-268-0227
Mailing Address - Fax:808-242-8786
Practice Address - Street 1:1540 LOWER MAIN ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1958
Practice Address - Country:US
Practice Address - Phone:808-243-1732
Practice Address - Fax:808-242-8786
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT20371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice