Provider Demographics
NPI:1477753283
Name:KOHEIL, AHMED (BDS, DDS, MS, FACP)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:KOHEIL
Suffix:
Gender:M
Credentials:BDS, DDS, MS, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6577 LYNX CV
Mailing Address - Street 2:
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-9535
Mailing Address - Country:US
Mailing Address - Phone:651-431-8149
Mailing Address - Fax:
Practice Address - Street 1:1710 S BUCKLEY RD UNIT 8A
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-5639
Practice Address - Country:US
Practice Address - Phone:303-696-6764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR3181223P0700X
CO10310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0700XDental ProvidersDentistProsthodontics