Provider Demographics
NPI:1376356758
Name:AMAZING SMILES DENTAL
Entity type:Organization
Organization Name:AMAZING SMILES DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FARID
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMIDZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-863-1315
Mailing Address - Street 1:61 S WILLARD ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-3419
Mailing Address - Country:US
Mailing Address - Phone:802-863-1315
Mailing Address - Fax:
Practice Address - Street 1:61 S WILLARD ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3419
Practice Address - Country:US
Practice Address - Phone:802-863-1315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty