Provider Demographics
NPI:1760496061
Name:S. AMIRANI DDS, PA
Entity Type:Organization
Organization Name:S. AMIRANI DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:AMIRANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:316-686-7155
Mailing Address - Street 1:1431 BLUFFVIEW ST
Mailing Address - Street 2:STE 212
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-3039
Mailing Address - Country:US
Mailing Address - Phone:316-686-7155
Mailing Address - Fax:316-686-4209
Practice Address - Street 1:1431 BLUFFVIEW ST
Practice Address - Street 2:STE 212
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-3039
Practice Address - Country:US
Practice Address - Phone:316-686-7155
Practice Address - Fax:316-686-4209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS70631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS116700OtherBLUE CROSS BLUE SHIELD ID