Provider Demographics
NPI:1598163974
Name:AKHTAR, AISHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:AISHA
Middle Name:
Last Name:AKHTAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E DEBBIE LN APT 3211
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3697
Mailing Address - Country:US
Mailing Address - Phone:631-748-1239
Mailing Address - Fax:
Practice Address - Street 1:4898 LITTLE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1054
Practice Address - Country:US
Practice Address - Phone:817-409-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX380491223G0001X
NY057687122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist