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NPI 1669857009

NPI 1669857009 : YASAMAN KAMALI DDS : PHILADELPHIA, PA

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General NPI Number Information
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    NPI Number           |    1669857009
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    Entity Type          |    Individual 
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    Provider Name        |    YASAMAN KAMALI DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/28/2015
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    Last Update Date     |    06/14/2016
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Provider Practice Location Address
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    Address Line         |    2459 ARAMINGO AVE 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19125-3731
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    Country              |    US
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    Telephone            |    215-427-2800
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2323 RACE ST UNIT 321 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19103-1075
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    Country              |    US
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    Telephone            |    310-779-7648
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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       |    DS040482
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    License Number State |    PA
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