Individual provider Active NPI

Ajay D Amin, DDS

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1659752137
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
100064 Issued in CA
Practice address
3625 Midway Dr Ste a
San Diego, CA 92110-5253
Phone
(619) 224-2204
NPI assigned
Jun 10, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE 60666476 WA
General Practice Dentistry 1223G0001X 100064 CA Primary

Addresses

Primary practice location

3625 Midway Dr Ste a
San Diego, CA 92110-5253

Mailing address

11760 Carmel Creek Rd Apt 305
San Diego, CA 92130-6612
Phone (951) 756-9019

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
100064CAMDGeneral Practice Dentistry
DE 60666476WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ajay D. Amin D.D.S. Inc. Past Accepting new patients
Larry a Woznuk DDS Inc Past Accepting new patients

Organizations & group practices 2

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": "1433894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1659752137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11760 CARMEL CREEK RD APT 305",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921306612",
            "telephone_number": "951-756-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 MIDWAY DR STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105253",
            "telephone_number": "619-224-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIN",
        "first_name": "AJAY",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-10",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 60666476",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.