# DR. MATIN MIKAYIL IMANGULI

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1114065406
- **Gender:** Man
- **Credential:** MD, DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401411071 | VA | — |
| 207Y00000X | Otolaryngology Physician | 25MA10294300 | NJ | — |
| 207Y00000X | Otolaryngology Physician | 36041 | AL | — |
| 207Y00000X | Otolaryngology Physician | Q0461 | TX | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 25MA10294300 | NJ | Yes |

## Other

- **Enumeration date:** 02/01/2007
- **Last updated:** 12/12/2023