Provider Demographics
NPI:1447322920
Name:ALBEIRUTI, AMRU (DDS)
Entity type:Individual
Prefix:DR
First Name:AMRU
Middle Name:
Last Name:ALBEIRUTI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5070 CASCADE RD SE STE 204
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8422
Mailing Address - Country:US
Mailing Address - Phone:616-805-5920
Mailing Address - Fax:
Practice Address - Street 1:5070 CASCADE RD SE STE 204
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8422
Practice Address - Country:US
Practice Address - Phone:616-805-5920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010186311223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics