Provider Demographics
NPI:1962546614
Name:AMINI, BEHNAM (DDS)
Entity type:Individual
Prefix:DR
First Name:BEHNAM
Middle Name:
Last Name:AMINI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:BEN
Other - Middle Name:
Other - Last Name:AMINI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:120 BATTERY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-4903
Mailing Address - Country:US
Mailing Address - Phone:415-310-1177
Mailing Address - Fax:
Practice Address - Street 1:120 BATTERY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-4903
Practice Address - Country:US
Practice Address - Phone:415-310-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA436801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice