Provider Demographics
NPI:1255348165
Name:ANDRADE, TERRI JYH (DDS)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:JYH
Last Name:ANDRADE
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 1:94-239 WAIPAHU DEPOT ST STE 208
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3056
Mailing Address - Country:US
Mailing Address - Phone:808-671-8784
Mailing Address - Fax:808-671-8784
Practice Address - Street 1:94-239 WAIPAHU DEPOT ST STE 208
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3056
Practice Address - Country:US
Practice Address - Phone:808-671-8784
Practice Address - Fax:808-671-8784
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-1821122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist