Healthcare Provider Details

I. General information

NPI: 1306764998
Provider Name (Legal Business Name): HUSSEIN SAMIR AMIRI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 PANAMA LN STE I
BAKERSFIELD CA
93313-3730
US

IV. Provider business mailing address

1310 S RED BLUFF LN
WALNUT CA
91789-3841
US

V. Phone/Fax

Practice location:
  • Phone: 661-584-4209
  • Fax:
Mailing address:
  • Phone: 909-551-9015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113377
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: