Provider Demographics
NPI:1033628342
Name:AHMED, AYAD YASEEN (DMD)
Entity Type:Individual
Prefix:
First Name:AYAD
Middle Name:YASEEN
Last Name:AHMED
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2285 NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-3447
Mailing Address - Country:US
Mailing Address - Phone:413-534-8700
Mailing Address - Fax:
Practice Address - Street 1:2285 NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-3447
Practice Address - Country:US
Practice Address - Phone:413-534-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857767122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty