Provider Demographics
NPI:1477635928
Name:FU, DERRICK C (DDS)
Entity type:Individual
Prefix:DR
First Name:DERRICK
Middle Name:C
Last Name:FU
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:1221 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 848
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814
Mailing Address - Country:US
Mailing Address - Phone:808-597-1221
Mailing Address - Fax:808-591-2070
Practice Address - Street 1:1221 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 848
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-597-1221
Practice Address - Fax:808-591-2070
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI15151223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics