Provider Demographics
NPI:1962022863
Name:AHMED, NAADIA SORAYA (DMD)
Entity Type:Individual
Prefix:DR
First Name:NAADIA
Middle Name:SORAYA
Last Name:AHMED
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 OLD GATE LN
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3612
Mailing Address - Country:US
Mailing Address - Phone:203-878-6699
Mailing Address - Fax:
Practice Address - Street 1:55 OLD GATE LN
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3612
Practice Address - Country:US
Practice Address - Phone:203-878-6699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT130421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program