Provider Demographics
NPI:1932830130
Name:SCHIAPPA, SPENCER ANTHONY (DMD)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:ANTHONY
Last Name:SCHIAPPA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1005 MOANALUA RD SPC 2000
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4700
Mailing Address - Country:US
Mailing Address - Phone:808-489-9530
Mailing Address - Fax:
Practice Address - Street 1:98-1005 MOANALUA RD SPC 2000
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4700
Practice Address - Country:US
Practice Address - Phone:808-489-9530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-2992122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice