Healthcare Provider Details

I. General information

NPI: 1356261143
Provider Name (Legal Business Name): AARON GOLDSTEIN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10573 W PICO BLVD # 136
LOS ANGELES CA
90064-2333
US

IV. Provider business mailing address

10573 W PICO BLVD # 136
LOS ANGELES CA
90064-2333
US

V. Phone/Fax

Practice location:
  • Phone: 424-256-6865
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number112232
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: