Provider Demographics
NPI:1689299174
Name:AMIR, JAMES (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:AMIR
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 1:11 FAIRFIELD CT
Mailing Address - Street 2:
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-5114
Mailing Address - Country:US
Mailing Address - Phone:201-694-3616
Mailing Address - Fax:
Practice Address - Street 1:142 TOTOWA RD STE 7
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2747
Practice Address - Country:US
Practice Address - Phone:201-694-3616
Practice Address - Fax:973-720-9527
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24856122300000X
NJ22DI02799300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist