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NPI Code Detail

MEDICARE: AMIR FEREYDOUNI, DMD

MEDICARE: AMIR FEREYDOUNI, DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1417544594
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMIR FEREYDOUNI, DMD
Provider Business Mailing Address
First Line : 5970 E 64TH AVE
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-3317
Country : US
Telephone Number : 303-495-2801
Fax Number :
Provider Business Practice Location Address
First Line : 5970 E 64TH AVE
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-3317
Country : US
Telephone Number : 303-495-2801
Fax Number :
Authorized Official
Title or Position : OWNER
Name : AMIR FEREYDOUNI
Credential : DMD
Telephone Number : 303-495-2801
Provider Enumeration Date : 12/23/2020
Last Update Date : 12/23/2020

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