Provider Demographics
NPI:1568779445
Name:AMIRI, NARIMAN (DDS)
Entity Type:Individual
Prefix:
First Name:NARIMAN
Middle Name:
Last Name:AMIRI
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 1:47 VALLEY AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-2252
Mailing Address - Country:US
Mailing Address - Phone:319-400-8089
Mailing Address - Fax:
Practice Address - Street 1:47 VALLEY AVE APT 9
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-2252
Practice Address - Country:US
Practice Address - Phone:319-400-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA302991223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics