Provider Demographics
NPI:1376233700
Name:ZAGHLOUL, ABDELRAHMAN MOHAMED
Entity type:Individual
Prefix:DR
First Name:ABDELRAHMAN
Middle Name:MOHAMED
Last Name:ZAGHLOUL
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 1:5969 E BROAD ST STE 303
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1539
Mailing Address - Country:US
Mailing Address - Phone:614-626-8822
Mailing Address - Fax:
Practice Address - Street 1:5969 E BROAD ST STE 303
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1539
Practice Address - Country:US
Practice Address - Phone:614-626-8822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.004589390200000X
OH30.028140122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program