Provider Demographics
NPI:1033177209
Name:HASHEMI, AMIR ALI (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:ALI
Last Name:HASHEMI
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 1:1642 RALSTON CIRCLE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-3801
Mailing Address - Country:US
Mailing Address - Phone:419-536-7265
Mailing Address - Fax:419-724-1651
Practice Address - Street 1:1642 RALSTON CIRCLE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-3801
Practice Address - Country:US
Practice Address - Phone:419-536-7265
Practice Address - Fax:419-724-1651
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-022692122300000X
CO8823122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2813610Medicaid