Provider Demographics
NPI:1699125534
Name:SOBHI, AMIR (DMD)
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:SOBHI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5432 E SOUTHERN AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-2772
Mailing Address - Country:US
Mailing Address - Phone:480-807-8100
Mailing Address - Fax:
Practice Address - Street 1:5432 E SOUTHERN AVE STE 108
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-2772
Practice Address - Country:US
Practice Address - Phone:480-807-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0094991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice