Provider Demographics
NPI:1346600053
Name:AGUILAR, LAUREN NICOLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:NICOLE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:NICOLE
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 WINDING RIVER LN STE 302
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-3569
Mailing Address - Country:US
Mailing Address - Phone:344-260-7025
Mailing Address - Fax:
Practice Address - Street 1:320 WINDING RIVER LN STE 302
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3569
Practice Address - Country:US
Practice Address - Phone:434-260-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16331122300000X
VA04014161831223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist