# AMIRI AND LUQUE DENTAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Oakland Dental Specialty Center, Oakland Dental Specialty Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407341621
- **Authorized official:** SUZANNE NIEMIEC (OFFICE MANAGER)
- **Authorized official phone:** (510) 256-7116

## Contact information

- **Practice address:** 8105 EDGEWATER DR STE 1, OAKLAND, CA 94621-2019
- **Practice address phone:** (510) 256-7116
- **Mailing address:** 8105 EDGEWATER DR STE 1, OAKLAND, CA 94621-2019
- **Mailing address phone:** (510) 256-7116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0300X | Periodontics | — | NULL | — |
| 1223P0300X | Periodontics | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 61795 | CA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | 102443 | CA | — |
| 261QD0000X | Dental Clinic/Center | 54003 | CA | — |

## Other

- **Enumeration date:** 06/29/2018
- **Last updated:** 06/29/2018