Provider Demographics
NPI:1255025359
Name:GAXHJA, AURORA (DMD)
Entity type:Individual
Prefix:
First Name:AURORA
Middle Name:
Last Name:GAXHJA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 WESTCHASE CT S
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-3886
Mailing Address - Country:US
Mailing Address - Phone:949-449-6638
Mailing Address - Fax:
Practice Address - Street 1:5710 N DAVIS HWY STE 1
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2039
Practice Address - Country:US
Practice Address - Phone:850-505-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.007355-C1122300000X
FL29323122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist