Provider Demographics
NPI:1043447980
Name:AMIN, EKTA (DMD)
Entity Type:Individual
Prefix:DR
First Name:EKTA
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 W IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-6901
Mailing Address - Country:US
Mailing Address - Phone:714-364-8181
Mailing Address - Fax:714-364-8181
Practice Address - Street 1:1030 W IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-6901
Practice Address - Country:US
Practice Address - Phone:714-364-8181
Practice Address - Fax:714-364-8108
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0378571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice