Provider Demographics
NPI:1023277324
Name:AHMAD, RIZWAN (DDS)
Entity type:Individual
Prefix:DR
First Name:RIZWAN
Middle Name:
Last Name:AHMAD
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 1:115 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5461
Mailing Address - Country:US
Mailing Address - Phone:301-777-7700
Mailing Address - Fax:301-777-7710
Practice Address - Street 1:115 MARKET ST
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-5461
Practice Address - Country:US
Practice Address - Phone:301-777-7700
Practice Address - Fax:301-777-7710
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14393122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist