Provider Demographics
NPI:1285668970
Name:AMIR, JAMIE NICHOLAS (BDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:NICHOLAS
Last Name:AMIR
Suffix:
Gender:M
Credentials:BDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 SE 17TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5519
Mailing Address - Country:US
Mailing Address - Phone:352-732-7050
Mailing Address - Fax:352-732-3500
Practice Address - Street 1:2710 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5519
Practice Address - Country:US
Practice Address - Phone:352-732-7050
Practice Address - Fax:352-732-3500
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17958122300000X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist