Provider Demographics
NPI:1053432328
Name:KOLINI, AMIR (DDS)
Entity type:Individual
Prefix:DR
First Name:AMIR
Middle Name:
Last Name:KOLINI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-1924
Mailing Address - Country:US
Mailing Address - Phone:925-376-0322
Mailing Address - Fax:510-750-2018
Practice Address - Street 1:3698 HIGHLAND RD APT C
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3590
Practice Address - Country:US
Practice Address - Phone:925-376-0322
Practice Address - Fax:925-376-0436
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA437071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice