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General NPI Number Information
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NPI Number | 1326761271
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Entity Type | Individual
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Provider Name | AARON SAN WONG
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Gender | Male
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 444 N WINCHESTER BLVD
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City | SANTA CLARA
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State | CA
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Zip | 95050-5749
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Country | US
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Telephone | 408-249-5121
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Fax |
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Provider Business Mailing Address
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Address Line | 2012 W ASH ST APT O07
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City | COLUMBIA
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State | MO
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Zip | 65203-1174
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Country | US
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Telephone | 510-417-5331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 108140
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License Number State | CA
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