Provider Demographics
NPI:1659501021
Name:AHMED, FATIMA (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:FATIMA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 FREESIA CT
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-1972
Mailing Address - Country:US
Mailing Address - Phone:734-998-3764
Mailing Address - Fax:
Practice Address - Street 1:1173 FREESIA CT
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-1972
Practice Address - Country:US
Practice Address - Phone:734-998-3764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010195521223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics