Provider Demographics
NPI:1013162155
Name:AMINI, RAMTIN (MD,DMD)
Entity type:Individual
Prefix:DR
First Name:RAMTIN
Middle Name:
Last Name:AMINI
Suffix:
Gender:M
Credentials:MD,DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5448 156TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5112
Mailing Address - Country:US
Mailing Address - Phone:617-515-5688
Mailing Address - Fax:
Practice Address - Street 1:15640 REDMOND WAY
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3831
Practice Address - Country:US
Practice Address - Phone:425-881-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-0361371223S0112X
WADE601124521223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery