Provider Demographics
NPI:1831502715
Name:HUSSEIN, AHMED (DDS)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:
Last Name:HUSSEIN
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 1:1837 AUSTIN AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-5388
Mailing Address - Country:US
Mailing Address - Phone:559-701-7447
Mailing Address - Fax:
Practice Address - Street 1:1837 AUSTIN AVE APT 101
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-5388
Practice Address - Country:US
Practice Address - Phone:559-701-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0586281223P0221X
CA1059661223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry