Provider Demographics
NPI:1417684606
Name:HUSSAIN, AMNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMNA
Middle Name:
Last Name:HUSSAIN
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 1:830 N ACACIA ST APT 1
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-8079
Mailing Address - Country:US
Mailing Address - Phone:310-972-1043
Mailing Address - Fax:
Practice Address - Street 1:830 N ACACIA ST APT 1
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-8079
Practice Address - Country:US
Practice Address - Phone:310-972-1043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-06
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107732122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist