Provider Demographics
NPI:1922448521
Name:RAHMAN, AKM TOUFIQUR (DDS)
Entity Type:Individual
Prefix:
First Name:AKM
Middle Name:TOUFIQUR
Last Name:RAHMAN
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 1:11662 STONEBROOK PL
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2720
Mailing Address - Country:US
Mailing Address - Phone:317-554-9566
Mailing Address - Fax:
Practice Address - Street 1:3658 S EAST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-1239
Practice Address - Country:US
Practice Address - Phone:317-554-9566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012008A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist