Provider Demographics
NPI:1164701934
Name:AHMED, SYED BILAL
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:BILAL
Last Name:AHMED
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 1:2165 CUNNINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2569
Mailing Address - Country:US
Mailing Address - Phone:757-827-5665
Mailing Address - Fax:757-896-3615
Practice Address - Street 1:2165 CUNNINGHAM DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2569
Practice Address - Country:US
Practice Address - Phone:757-827-5665
Practice Address - Fax:757-896-3615
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413255122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist