Individual provider · NPI-1

Dr. Maryam Amidi, DDS

Dentist, General Practice · Mountain View, CA

NPI number1891882114
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1891882114
Entity type
Individual (NPI-1)
Name
Dr. Maryam Amidi
Credential
DDS
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 6, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice51040CAYes

Practice location

1039 El Monte Ave
Suite # E
Mountain View, CA 94040-2370

Phone 650-988-6500 · Fax 650-988-6655

Mailing address

1100 Sharon Park Dr
Apt# 24
Menlo Park, CA 94025-7009

Phone 650-380-8680 · Fax 650-988-6655

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