Healthcare Provider Details

I. General information

NPI: 1225136005
Provider Name (Legal Business Name): AARON ESCALANTE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 KEARNEY ST
EL CERRITO CA
94530-2810
US

IV. Provider business mailing address

901 KEARNEY ST
EL CERRITO CA
94530-2810
US

V. Phone/Fax

Practice location:
  • Phone: 510-526-1381
  • Fax: 510-526-8750
Mailing address:
  • Phone: 510-526-1381
  • Fax: 510-526-8750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number34608
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: