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General NPI Number Information
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NPI Number | 1043198955
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Entity Type | Individual
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Provider Name | AIGERIM AMANOVA DDS
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Gender | Female
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 463 CANYON DEL REY BLVD
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City | DEL REY OAKS
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State | CA
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Zip | 93940-5705
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Country | US
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Telephone | 831-920-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 22 VIA CASTANADA
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City | MONTEREY
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State | CA
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Zip | 93940-6015
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Country | US
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Telephone | 858-257-8168
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 111946
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License Number State | CA
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