Provider Demographics
NPI:1336271683
Name:ZAMANI, AMIR (DDS)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:ZAMANI
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 1:17107 BRIARDALE RD
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2076
Mailing Address - Country:US
Mailing Address - Phone:301-990-1074
Mailing Address - Fax:
Practice Address - Street 1:1 CRYSTAL PLAZA S 2111
Practice Address - Street 2:JEFFERSON DAVIS HWY
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202
Practice Address - Country:US
Practice Address - Phone:703-415-0505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014110391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice