Provider Demographics
NPI:1356760896
Name:KINJAWI, AMJAD (DMD)
Entity type:Individual
Prefix:
First Name:AMJAD
Middle Name:
Last Name:KINJAWI
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 1:380 ELM ST STE 5
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-3314
Mailing Address - Country:US
Mailing Address - Phone:508-399-8800
Mailing Address - Fax:508-399-7744
Practice Address - Street 1:380 ELM ST STE 5
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-6739
Practice Address - Country:US
Practice Address - Phone:508-399-8800
Practice Address - Fax:508-399-7744
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19838122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist