Provider Demographics
NPI:1114390366
Name:TAKIGAWA, AARON MITCHELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:MITCHELL
Last Name:TAKIGAWA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OSBORN ST STE 150
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-8656
Mailing Address - Country:US
Mailing Address - Phone:949-333-5285
Mailing Address - Fax:949-551-9738
Practice Address - Street 1:2 OSBORN ST STE 150
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8656
Practice Address - Country:US
Practice Address - Phone:949-333-5285
Practice Address - Fax:949-551-9738
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64163122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist