Provider Demographics
NPI:1053725457
Name:AMINI-SAMI, ASHLEY ALI (DMD,PHD,MMSC)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:ALI
Last Name:AMINI-SAMI
Suffix:
Gender:F
Credentials:DMD,PHD,MMSC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ALI
Other - Last Name:AMINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD, PHD
Mailing Address - Street 1:188 LONGWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-432-1474
Mailing Address - Fax:
Practice Address - Street 1:188 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-432-1474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18565331223P0700X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0700XDental ProvidersDentistProsthodontics