Healthcare Provider Details

I. General information

NPI: 1952289753
Provider Name (Legal Business Name): KAY-WAN KEVIN AMINZADEH DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16201 E INDIANA AVE STE 3240
SPOKANE VALLEY WA
99216-2838
US

IV. Provider business mailing address

16201 E INDIANA AVE STE 3240
SPOKANE VALLEY WA
99216-2838
US

V. Phone/Fax

Practice location:
  • Phone: 509-934-4584
  • Fax:
Mailing address:
  • Phone: 509-934-4584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDE61632478
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: