Provider Demographics
NPI:1831880590
Name:BIBAT, JANNA LIZ TUAZON (DMD)
Entity type:Individual
Prefix:DR
First Name:JANNA LIZ
Middle Name:TUAZON
Last Name:BIBAT
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 1:91-1358 KARAYAN ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1984
Mailing Address - Country:US
Mailing Address - Phone:808-738-7934
Mailing Address - Fax:
Practice Address - Street 1:91-1358 KARAYAN ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-1984
Practice Address - Country:US
Practice Address - Phone:808-738-7934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program