Healthcare Provider Details

I. General information

NPI: 1225871585
Provider Name (Legal Business Name): MR. AMIN ESLAMI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 CHUM CRK RD STE 100 -CHILDREN'S CHOICE DENTAL CARE
REDDING CA
96003
US

IV. Provider business mailing address

2800 BARTONS BLUFF LN APT #1604
AUSTIN TX
78746
US

V. Phone/Fax

Practice location:
  • Phone: 346-770-8133
  • Fax:
Mailing address:
  • Phone: 346-770-8133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113338
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: