Provider Demographics
NPI:1154843985
Name:NADEEM, AHSEN
Entity Type:Individual
Prefix:DR
First Name:AHSEN
Middle Name:
Last Name:NADEEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18215 NE 95TH WAY UNIT 104
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-8633
Mailing Address - Country:US
Mailing Address - Phone:253-508-2882
Mailing Address - Fax:
Practice Address - Street 1:18215 NE 95TH WAY UNIT 104
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-8633
Practice Address - Country:US
Practice Address - Phone:253-508-2882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60771773122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist