Provider Demographics
NPI:1801858592
Name:AMINPOUR, BABAK (DDS)
Entity Type:Individual
Prefix:
First Name:BABAK
Middle Name:
Last Name:AMINPOUR
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 1:3733 ARLINGTON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2651
Mailing Address - Country:US
Mailing Address - Phone:951-788-7701
Mailing Address - Fax:951-788-6428
Practice Address - Street 1:3733 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2650
Practice Address - Country:US
Practice Address - Phone:951-788-7701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ201101223S0112X
CA552201223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery