Provider Demographics
NPI:1104815513
Name:AGHI, APARNA (DMD)
Entity type:Individual
Prefix:MRS
First Name:APARNA
Middle Name:
Last Name:AGHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:APARNA
Other - Middle Name:
Other - Last Name:KHANNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:912 GRAND AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3552
Mailing Address - Country:US
Mailing Address - Phone:617-359-9271
Mailing Address - Fax:
Practice Address - Street 1:912 GRAND AVE STE 202
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3552
Practice Address - Country:US
Practice Address - Phone:415-459-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA566511223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30301490Medicaid