Provider Demographics
NPI:1891346003
Name:AHMAD, ABDULLAH (DMD)
Entity Type:Individual
Prefix:DR
First Name:ABDULLAH
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 W TONTO RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-9222
Mailing Address - Country:US
Mailing Address - Phone:914-621-6878
Mailing Address - Fax:
Practice Address - Street 1:10220 W BELL RD STE 104
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1179
Practice Address - Country:US
Practice Address - Phone:623-300-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-28
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD010437122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist