Provider Demographics
NPI:1447373725
Name:DIERENFIELD, DOUGLAS H (DDS)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:H
Last Name:DIERENFIELD
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 1:75-6082 ALII DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-4303
Mailing Address - Country:US
Mailing Address - Phone:808-329-5251
Mailing Address - Fax:808-329-4097
Practice Address - Street 1:75-6082 ALII DR
Practice Address - Street 2:SUITE D
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-4303
Practice Address - Country:US
Practice Address - Phone:808-329-5251
Practice Address - Fax:808-329-4097
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice