Healthcare Provider Details

I. General information

NPI: 1942070354
Provider Name (Legal Business Name): AMRIT MIR DR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMRIT MIR BDS, M.S

II. Dates (important events)

Enumeration Date: 01/05/2024
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 MAIN ST
BUFFALO NY
14214-3099
US

IV. Provider business mailing address

8877 GREINER RD
CLARENCE NY
14031-1102
US

V. Phone/Fax

Practice location:
  • Phone: 716-829-3332
  • Fax:
Mailing address:
  • Phone: 518-488-7487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901603282
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number000153-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: