Provider Demographics
NPI:1508961327
Name:AOKI, ALAN N (DDS)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:N
Last Name:AOKI
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 1:1756 KENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-3745
Mailing Address - Country:US
Mailing Address - Phone:801-556-2324
Mailing Address - Fax:
Practice Address - Street 1:1365 W 1000 N
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84116-1654
Practice Address - Country:US
Practice Address - Phone:801-328-5756
Practice Address - Fax:801-521-7463
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT143784-9923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTV07862Medicare UPIN