Amir Itani, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

17303 Issued in MD

Practice address

4701 Randolph Rd Ste G10
Rockville, MD 20852-2259

Phone

(301) 468-0020

NPI assigned

Mar 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 14, 2023 through Sep 14, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Bluhm, Dorsch and Vandervort, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Ashburn, VA
  • NPI 1265578413
  NPD (past)
• Washington Oral & Facial Surgery, PC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Washington, DC
  • NPI 1962668293
  NPD (past)

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1932604501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N RANDOLPH ST APT 1200",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222032188",
            "telephone_number": "240-393-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD STE G10",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522259",
            "telephone_number": "301-468-0020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1234 19th St NW Ste 508",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200362446",
            "country_code": "US",
            "telephone_number": "202-223-3391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ITANI",
        "first_name": "AMIR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DC",
            "license": "DEN2000121",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "17303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Issa Physical Therapy, Inc.
• Marvie Issa
• Tamer S. Issa, PT, DPT
• Lawrence Ian Issadore
• Salem Isuwa
• David Itskevich, D.O.
• Molondo Ituka
• Ivymount Outreach Programs, Inc
• Adesua Franca Iweze
• Vasantha Iyengar, MD

• Oral and Maxillofacial Surgery (Dentist) in Rockville, MD
• Providers in Rockville, MD by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.