Provider Demographics
NPI:1083080246
Name:AMINA, FARHEEN (DDS)
Entity Type:Individual
Prefix:
First Name:FARHEEN
Middle Name:
Last Name:AMINA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3904 HULL STREET RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-1714
Mailing Address - Country:US
Mailing Address - Phone:804-233-0007
Mailing Address - Fax:804-562-8100
Practice Address - Street 1:3904 HULL STREET RD
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-1714
Practice Address - Country:US
Practice Address - Phone:804-233-0007
Practice Address - Fax:804-562-8100
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014153371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice