Provider Demographics
NPI:1396224515
Name:AMIN, OMAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:AMIN
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 1:4322 APRIL MEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3114
Mailing Address - Country:US
Mailing Address - Phone:281-782-8237
Mailing Address - Fax:
Practice Address - Street 1:200 S WAYSIDE DR # A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-4632
Practice Address - Country:US
Practice Address - Phone:713-926-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34506122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist