Provider Demographics
NPI:1033670757
Name:NAFFI, AMIR (DMD,MS)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:NAFFI
Suffix:
Gender:M
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 ALHAMBRA CREST DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-7915
Mailing Address - Country:US
Mailing Address - Phone:862-699-8577
Mailing Address - Fax:
Practice Address - Street 1:6302 MANATEE AVE W STE A
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2355
Practice Address - Country:US
Practice Address - Phone:941-792-2965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10254122300000X
FLDN24074122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist