Provider Demographics
NPI:1447429279
Name:ISHITA RAHMAN DMD LLC
Entity Type:Organization
Organization Name:ISHITA RAHMAN DMD LLC
Other - Org Name:WEST ANNAPOLIS FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DODSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-263-3700
Mailing Address - Street 1:101 RIDGELY AVE
Mailing Address - Street 2:STE 20
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1409
Mailing Address - Country:US
Mailing Address - Phone:410-263-3700
Mailing Address - Fax:410-268-4925
Practice Address - Street 1:101 RIDGELY AVE
Practice Address - Street 2:STE 20
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1409
Practice Address - Country:US
Practice Address - Phone:410-263-3700
Practice Address - Fax:410-268-4925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty