Provider Demographics
NPI:1295706067
Name:ARONHIME, SAMUEL S (DENTIST)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:S
Last Name:ARONHIME
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 754
Mailing Address - Street 2:8360 WEST MAIN STREET
Mailing Address - City:MARSHALL
Mailing Address - State:VA
Mailing Address - Zip Code:20115
Mailing Address - Country:US
Mailing Address - Phone:540-364-2400
Mailing Address - Fax:540-364-3625
Practice Address - Street 1:8360 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:VA
Practice Address - Zip Code:20115
Practice Address - Country:US
Practice Address - Phone:540-364-2400
Practice Address - Fax:540-364-3625
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7798122300000X
VA0401411363122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN