Provider Demographics
NPI:1205261344
Name:MUHIEDDINE, AHMAD K (DMD)
Entity type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:K
Last Name:MUHIEDDINE
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 1:14811 HILLIARD RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4005
Mailing Address - Country:US
Mailing Address - Phone:216-496-1755
Mailing Address - Fax:
Practice Address - Street 1:27127 CHARDON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1115
Practice Address - Country:US
Practice Address - Phone:440-943-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30024071122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist