Provider Demographics
NPI:1508434630
Name:AMINE, AHMED HUSSEIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:HUSSEIN
Last Name:AMINE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7057 YINGER AVE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1732
Mailing Address - Country:US
Mailing Address - Phone:313-433-4106
Mailing Address - Fax:
Practice Address - Street 1:3113 OAKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:MELVINDALE
Practice Address - State:MI
Practice Address - Zip Code:48122-1211
Practice Address - Country:US
Practice Address - Phone:313-381-3850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601018122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist