Provider Demographics
NPI:1457643256
Name:BEXTON, TAMARA CHRISTINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:CHRISTINE
Last Name:BEXTON
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:PO BOX 790829
Mailing Address - Street 2:
Mailing Address - City:PAIA
Mailing Address - State:HI
Mailing Address - Zip Code:96779-0829
Mailing Address - Country:US
Mailing Address - Phone:808-283-5456
Mailing Address - Fax:808-873-8097
Practice Address - Street 1:81 MAKAWAO AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-8895
Practice Address - Country:US
Practice Address - Phone:808-572-9461
Practice Address - Fax:808-572-8323
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2428122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist