Provider Demographics
NPI:1053953604
Name:IMRAN, AMNA (DDS)
Entity type:Individual
Prefix:DR
First Name:AMNA
Middle Name:
Last Name:IMRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7004 WIND ROW DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8627
Mailing Address - Country:US
Mailing Address - Phone:832-919-4271
Mailing Address - Fax:
Practice Address - Street 1:7004 WIND ROW DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-8627
Practice Address - Country:US
Practice Address - Phone:832-919-4271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice