Provider Demographics
NPI:1659395408
Name:ARAGON, DENNIS EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:EUGENE
Last Name:ARAGON
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 1:800 MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-4046
Mailing Address - Country:US
Mailing Address - Phone:505-454-0631
Mailing Address - Fax:505-454-0236
Practice Address - Street 1:800 MILLS AVE
Practice Address - Street 2:DENNIS E. ARAGON, D.D. S
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4046
Practice Address - Country:US
Practice Address - Phone:505-454-0631
Practice Address - Fax:505-454-0236
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMD13911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM111044OtherUNITED CONCORDIA