Provider Demographics
NPI:1972236503
Name:AMINI-LUTHER, DANIELLE A (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:A
Last Name:AMINI-LUTHER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14820 MICHELE DR
Mailing Address - Street 2:
Mailing Address - City:GLENELG
Mailing Address - State:MD
Mailing Address - Zip Code:21737-9416
Mailing Address - Country:US
Mailing Address - Phone:443-812-6754
Mailing Address - Fax:
Practice Address - Street 1:9099 RIDGEFIELD DR STE 206
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6720
Practice Address - Country:US
Practice Address - Phone:301-663-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD175581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice