1609048834 NPI number — STARLING ORTHODONTICS, PLLC

Table of content: DR. AARON DOUGLAS WILKIN D.C. (NPI 1972790525)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609048834 NPI number — STARLING ORTHODONTICS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STARLING ORTHODONTICS, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609048834
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1177 OLD HICKORY BLVD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-4241
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-507-1660
Provider Business Mailing Address Fax Number:
615-507-1661

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1177 OLD HICKORY BLVD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
BRENTWOOD
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37027-4241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-507-1660
Provider Business Practice Location Address Fax Number:
615-507-1661
Provider Enumeration Date:
03/27/2008

Additional Information

Authorized Official

Authorized Official Last Name:
STARLING
Authorized Official First Name:
CRAIG
Authorized Official Middle Name:
M
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
615-507-1660

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X , with the licence number:  8201 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9177357 . This is a "DORAL DENTAL USA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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