Healthcare Provider Details

I. General information

NPI: 1245530062
Provider Name (Legal Business Name): AARON MICHAEL BJARNASON D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2010
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HARTNELL AVE
REDDING CA
96002-1848
US

IV. Provider business mailing address

400 HARTNELL AVE
REDDING CA
96002-1848
US

V. Phone/Fax

Practice location:
  • Phone: 530-222-2473
  • Fax:
Mailing address:
  • Phone: 530-222-2473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number62303
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: