Provider Demographics
NPI:1821357740
Name:STUMP, AARON JAIRUS (DDS)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:JAIRUS
Last Name:STUMP
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 1:2036 N PROSPECT AVE UNIT 1007
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1263
Mailing Address - Country:US
Mailing Address - Phone:317-260-9967
Mailing Address - Fax:
Practice Address - Street 1:229 CONNOR DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-5604
Practice Address - Country:US
Practice Address - Phone:434-975-7336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-12
Last Update Date:2012-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014135551223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry