Aragon Ellwanger

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

59576 Issued in CA

Practice address

1655 Southgate Ave Ste 200
Daly City, CA 94015-2302

Phone

(650) 991-0999

NPI assigned

Sep 17, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1265740781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 THE ALAMEDA UNIT 370",
            "city": "SAN JUAN BAUTISTA",
            "state": "CA",
            "postal_code": "950457012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 SOUTHGATE AVE STE 200",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152302",
            "telephone_number": "650-991-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLWANGER",
        "first_name": "ARAGON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-17",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "59576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleanor S Tucker, DDS
• Elite Prime Care
• Ellick Tsang M D Corporation
• Dara Bu Elliott
• Laurel M Elliott, LMFT #141619
• Angela Embalzado
• Nitarin Emmanuel
• Encare Hospice LLC
• Scott F Enderby, D.O.
• Dominic Enis-Mitchell

• Oral and Maxillofacial Surgery (Dentist) in Daly City, CA
• Providers in Daly City, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.