MEDICARE: DR. AMIN KAZEMI D.M.D., M.D.

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
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DS029879L	PA

General Provider Information

NPI Number	:	1720124746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMIN KAZEMI D.M.D., M.D.

Provider Business Mailing Address
First Line	:	600 E MARSHALL ST STE 106
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-4443
Country	:	US
Telephone Number	:	610-431-2161
Fax Number	:	610-431-2173

Provider Business Practice Location Address
First Line	:	600 E MARSHALL ST STE 106
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-4443
Country	:	US
Telephone Number	:	610-431-2161
Fax Number	:	610-431-2173

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	04/27/2021

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