Healthcare Provider Details

I. General information

NPI: 1205744497
Provider Name (Legal Business Name): EMAD AMINI FAMILY DENTAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 STORY RD STE 100
SAN JOSE CA
95122-1927
US

IV. Provider business mailing address

1775 STORY RD STE 100
SAN JOSE CA
95122-1927
US

V. Phone/Fax

Practice location:
  • Phone: 818-312-8552
  • Fax:
Mailing address:
  • Phone: 818-312-8552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SEYED EMADALDIN AMINI
Title or Position: CEO
Credential: DMD
Phone: 818-312-8552