Provider Demographics
NPI:1861844151
Name:HAMIDI, ERIC (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:HAMIDI
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 1:4380 S SYRACUSE ST
Mailing Address - Street 2:#504
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2607
Mailing Address - Country:US
Mailing Address - Phone:303-741-1011
Mailing Address - Fax:303-741-1189
Practice Address - Street 1:4380 S SYRACUSE ST
Practice Address - Street 2:#504
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2607
Practice Address - Country:US
Practice Address - Phone:303-741-1011
Practice Address - Fax:303-741-1189
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6988122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist