Provider Demographics
NPI:1568197176
Name:AHMED, ARSALAA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARSALAA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ARSALA
Other - Middle Name:
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2565 HERMITAGE DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6395
Mailing Address - Country:US
Mailing Address - Phone:404-547-7398
Mailing Address - Fax:
Practice Address - Street 1:222 12TH ST NE STE 1A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-4013
Practice Address - Country:US
Practice Address - Phone:404-873-2957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN122723122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist