=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598375131
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMIR ALI AMIR ASLANI DMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2020
-----------------------------------------------------
Last Update Date | 02/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13334 LIMONITE AVE STE 120
-----------------------------------------------------
City | EASTVALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92880-7257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-228-9294
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 640 S CURSON AVE APT 904
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90036-5933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-862-9394
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0300X
-----------------------------------------------------
Taxonomy Name | Periodontics
-----------------------------------------------------
License Number | DDS111485
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------