Provider Demographics
NPI:1609271527
Name:EDWARDS, AARON (DMD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:EDWARDS
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 1:21954 KINGSLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2428
Mailing Address - Country:US
Mailing Address - Phone:281-392-2061
Mailing Address - Fax:281-392-2066
Practice Address - Street 1:21954 KINGSLAND BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2428
Practice Address - Country:US
Practice Address - Phone:281-392-2061
Practice Address - Fax:281-392-2066
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30520122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist