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General NPI Number Information
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NPI Number | 1417244039
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Entity Type | Individual
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Provider Name | FARHAD AMINI DDS
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Gender | Male
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Dates
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Enumeration Date | 07/03/2011
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 259 E WORKMAN ST
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City | COVINA
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State | CA
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Zip | 91723-3507
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Country | US
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Telephone | 714-282-9966
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Fax | 714-282-9969
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Provider Business Mailing Address
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Address Line | 259 E WORKMAN ST
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City | COVINA
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State | CA
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Zip | 91723-3507
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Country | US
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Telephone | 714-395-3009
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901020414
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 62172
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License Number State | CA
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