Provider Demographics
NPI:1477165561
Name:MEKIC, AMINA (DMD)
Entity type:Individual
Prefix:
First Name:AMINA
Middle Name:
Last Name:MEKIC
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 1:2103 OAKCLIFFE CT
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-6701
Mailing Address - Country:US
Mailing Address - Phone:610-360-2785
Mailing Address - Fax:
Practice Address - Street 1:8732 UNIVERSITY CITY BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-3558
Practice Address - Country:US
Practice Address - Phone:704-549-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401417125122300000X
NC13662122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0401417125OtherVIRGINIA DEPARTMENT OF HEALTH PROFESSIONALS BOARD OF DENTISTRY
NC13662OtherNORTH CAROLINA STATE BOARD OF DENTAL EXAMINERS