Healthcare Provider Details

I. General information

NPI: 1639493281
Provider Name (Legal Business Name): AARON URBAN ADAMSON DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 09/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 BRINKBY AVE STE. 1
RENO NV
89509-4348
US

IV. Provider business mailing address

2453 GRANITE SPRINGS RD
RENO NV
89519-7365
US

V. Phone/Fax

Practice location:
  • Phone: 775-826-7833
  • Fax: 775-826-6017
Mailing address:
  • Phone: 925-997-3496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number7670479-9921
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number63189
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberS2-134C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: