Provider Demographics
NPI:1578269783
Name:AHRAR, HOOMAN
Entity Type:Individual
Prefix:
First Name:HOOMAN
Middle Name:
Last Name:AHRAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5049 COURTLAND RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-2432
Mailing Address - Country:US
Mailing Address - Phone:352-442-2662
Mailing Address - Fax:
Practice Address - Street 1:5049 COURTLAND RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-2432
Practice Address - Country:US
Practice Address - Phone:352-442-2662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108535122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist