Provider Demographics
NPI:1235948076
Name:TERUYA, KATHRYN (DDS, MS)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:TERUYA
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 ONAHA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5107
Mailing Address - Country:US
Mailing Address - Phone:808-927-5048
Mailing Address - Fax:
Practice Address - Street 1:9067 POPLAR AVE STE 113
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-7851
Practice Address - Country:US
Practice Address - Phone:901-723-2103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN126981223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics