Provider Demographics
NPI:1831156322
Name:CHRISTENSEN, AARON ALLEN (DMD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:ALLEN
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 HARRISON BLVD
Mailing Address - Street 2:STE 1
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-2081
Mailing Address - Country:US
Mailing Address - Phone:801-627-1221
Mailing Address - Fax:
Practice Address - Street 1:3550 HARRISON BLVD
Practice Address - Street 2:STE 1
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2081
Practice Address - Country:US
Practice Address - Phone:801-627-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT376282-99231223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806116300Medicaid
UT03762829900001OtherBCBS
01320903OtherTRICARE
WY117449500Medicaid