Provider Demographics
NPI:1477239788
Name:IBRAHIM, AHMED RAMADAN (DMD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:RAMADAN
Last Name:IBRAHIM
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 1:7263 HUNTERDON DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6144
Mailing Address - Country:US
Mailing Address - Phone:407-285-8091
Mailing Address - Fax:
Practice Address - Street 1:3907 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5209
Practice Address - Country:US
Practice Address - Phone:407-228-0132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28246122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist