Healthcare Provider Details

I. General information

NPI: 1801750609
Provider Name (Legal Business Name): AMANI AULAKH
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 OLNEY SANDY SPRING RD
OLNEY MD
20832-1408
US

IV. Provider business mailing address

13805 VANDERBILT WAY
LAUREL MD
20707-9521
US

V. Phone/Fax

Practice location:
  • Phone: 240-665-5485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18959
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: