Provider Demographics
NPI:1205321510
Name:ABDELHAMID, AHMAD (DDS)
Entity type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:
Last Name:ABDELHAMID
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 1:3377 KINGS MILL RUN
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3957
Mailing Address - Country:US
Mailing Address - Phone:216-200-1400
Mailing Address - Fax:
Practice Address - Street 1:3235 MANCHESTER RD STE 2
Practice Address - Street 2:
Practice Address - City:COVENTRY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44319-1457
Practice Address - Country:US
Practice Address - Phone:330-645-9180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH30.026274122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program