Individual provider Active NPI

Aiman Pourahmari, DE 61297295

  • General Practice Dentistry
  • Lynnwood, WA
National Provider Identifier
1114659976
Registry record updated Feb 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE61297295 Issued in WA
Practice address
19020 33Rd Ave W Ste 380
Lynnwood, WA 98036-4754
Phone
(425) 774-0111
NPI assigned
Jun 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE61297295 WA Primary

Addresses

Primary practice location

19020 33Rd Ave W Ste 380
Lynnwood, WA 98036-4754

Mailing address

19020 33Rd Ave W
Lynnwood, WA 98036-4746
Phone (425) 774-0111

Other practice location 1

8309 165th Ave NE Ste 101
Redmond, WA 98052-3939
Phone (425) 307-1317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE61297295WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Amanpreet Sidhu PLLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1114659976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364746",
            "telephone_number": "425-774-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 380",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364754",
            "telephone_number": "425-774-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8309 165th Ave NE Ste 101",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980523939",
            "country_code": "US",
            "telephone_number": "425-307-1317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POURAHMARI",
        "first_name": "AIMAN",
        "credential": "DE 61297295",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61297295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.