Provider Demographics
NPI:1699269902
Name:AMIN, AMIT (DDS)
Entity type:Individual
Prefix:
First Name:AMIT
Middle Name:
Last Name:AMIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3663 WASHINGTON AVE APT 6040
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-6480
Mailing Address - Country:US
Mailing Address - Phone:704-654-2651
Mailing Address - Fax:
Practice Address - Street 1:11201 BELLAIRE BLVD STE A-18
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2566
Practice Address - Country:US
Practice Address - Phone:281-568-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX407271223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty