Provider Demographics
NPI:1194487959
Name:OUBAID, AHMAD (DMD)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:
Last Name:OUBAID
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 1:650 S GAINES ST APT 2108
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4772
Mailing Address - Country:US
Mailing Address - Phone:857-267-1265
Mailing Address - Fax:
Practice Address - Street 1:443 NW BURNSIDE RD
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3714
Practice Address - Country:US
Practice Address - Phone:503-492-8487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD11549122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist