Individual provider Active NPI

Terri J.Y.H. Andrade, D.D.S.

  • Dentist
  • Waipahu, HI
National Provider Identifier
1255348165
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DT-1821 Issued in HI
Practice address
94-239 Waipahu Depot St Ste 208
Waipahu, HI 96797-3056
Phone
(808) 671-8784
Fax
(808) 671-8784
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DT-1821 HI Primary

Addresses

Primary practice location

94-239 Waipahu Depot St Ste 208
Waipahu, HI 96797-3056

Mailing address

94-239 Waipahu Depot St Ste 208
Waipahu, HI 96797-3056
Phone (808) 671-8784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720003160 HI Order and Referring Only - DentistPractitioner - Dentist 3971816968

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DT-1821HIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Terri Andrade, DDS Current Accepting new patients

Locations

94-239 Waipahu Depot St
Ste 208
Waipahu, HI 96797
Phone (808) 671-8784

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255348165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-239 WAIPAHU DEPOT ST STE 208",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973056",
            "telephone_number": "808-671-8784",
            "fax_number": "808-671-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-239 WAIPAHU DEPOT ST STE 208",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967973056",
            "telephone_number": "808-671-8784",
            "fax_number": "808-671-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "TERRI",
        "middle_name": "J.Y.H.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT-1821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

Verify at the official NPI Registry.