Provider Demographics
NPI:1720636509
Name:TUMANENG, BRITNEY
Entity Type:Individual
Prefix:
First Name:BRITNEY
Middle Name:
Last Name:TUMANENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-951 HIAPO ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-2804
Mailing Address - Country:US
Mailing Address - Phone:808-351-4371
Mailing Address - Fax:
Practice Address - Street 1:94-951 HIAPO ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2804
Practice Address - Country:US
Practice Address - Phone:808-351-4371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDH-2217124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist