Provider Demographics
NPI:1457473373
Name:AHED, ABDUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:
Last Name:AHED
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7441 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:WORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60482-1005
Mailing Address - Country:US
Mailing Address - Phone:708-448-0468
Mailing Address - Fax:708-448-4456
Practice Address - Street 1:7441 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:WORTH
Practice Address - State:IL
Practice Address - Zip Code:60482-1005
Practice Address - Country:US
Practice Address - Phone:708-448-0468
Practice Address - Fax:708-448-4456
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0150441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice