Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DE60112452 | WA |
N | 1223S0112X | Oral and Maxillofacial Surgeon | DS-036137 | PA |
NPI | 1013162155 |
---|---|
Provider Name | Dr. Ramtin Amini |
First Address | Bellevue, WA 98006-5112 |
Second Address | Redmond, WA 98052-3831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2008 |
Last Update Date | 26/08/2016 |