Provider Demographics
NPI:1366981938
Name:JOHNSON, ANDREW HO'OLA'IKU (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:HO'OLA'IKU
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 S BERETANIA ST STE 304
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2551
Mailing Address - Country:US
Mailing Address - Phone:808-531-5071
Mailing Address - Fax:
Practice Address - Street 1:848 S BERETANIA ST STE 304
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2551
Practice Address - Country:US
Practice Address - Phone:808-531-5071
Practice Address - Fax:808-536-1424
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI27291223G0001X
HIDT-2729122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice