Provider Demographics
NPI:1821986175
Name:AIDUN, AUTRIA (DDS)
Entity type:Individual
Prefix:DR
First Name:AUTRIA
Middle Name:
Last Name:AIDUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16210 JACARANDA WAY
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3629
Mailing Address - Country:US
Mailing Address - Phone:408-458-6106
Mailing Address - Fax:
Practice Address - Street 1:16210 JACARANDA WAY
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3629
Practice Address - Country:US
Practice Address - Phone:408-458-6106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111771122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist