Active NPI
Nikolas Parham Amini, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Jacksonville, FL
National Provider Identifier
1225636897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN23904
- Practice address
- 5116 Blanding Blvd
Jacksonville, FL 32210-7840 - Phone
- (904) 573-7900
- Fax
- (904) 903-4537
- NPI assigned
- Oct 15, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN23904 | FL | Primary |
Addresses
Primary practice location
5116 Blanding Blvd
Jacksonville, FL 32210-7840
Mailing address
600 Technology Park Ste 101
Lake Mary, FL 32746-7122
Phone (407) 543-8509
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN23904 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602806400000",
"number": "1225636897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 TECHNOLOGY PARK STE 101",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327467122",
"telephone_number": "407-543-8509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5116 BLANDING BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322107840",
"telephone_number": "904-573-7900",
"fax_number": "904-903-4537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMINI",
"first_name": "NIKOLAS",
"middle_name": "PARHAM",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-15",
"last_updated": "2020-10-16",
"certification_date": "2020-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "FL",
"license": "DN23904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.