Provider Demographics
NPI:1578035531
Name:IQBAL, AHSAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:AHSAN
Middle Name:
Last Name:IQBAL
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 1:2200 N URSULA ST APT 159
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7602
Mailing Address - Country:US
Mailing Address - Phone:972-821-8634
Mailing Address - Fax:
Practice Address - Street 1:7500 E ARAPAHOE RD STE 202
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1277
Practice Address - Country:US
Practice Address - Phone:303-495-3443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00203838122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist