Provider Demographics
NPI:1982084273
Name:ENGLUND, BETHANY (DDS)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:ENGLUND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 KAPIOLANI BLVD
Mailing Address - Street 2:APT 3510
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-4485
Mailing Address - Country:US
Mailing Address - Phone:206-919-7348
Mailing Address - Fax:
Practice Address - Street 1:45-718 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2947
Practice Address - Country:US
Practice Address - Phone:808-247-6658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63901122300000X
HIDT-2640122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist