Provider Demographics
NPI:1245891829
Name:DEAN N. AHMAD DDS INC.
Entity type:Organization
Organization Name:DEAN N. AHMAD DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:COMEL
Authorized Official - Middle Name:REHMAN
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-705-5754
Mailing Address - Street 1:580 N SUNRISE AVE STE 190
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3035
Mailing Address - Country:US
Mailing Address - Phone:916-772-0112
Mailing Address - Fax:916-772-0133
Practice Address - Street 1:580 N SUNRISE AVE STE 190
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3035
Practice Address - Country:US
Practice Address - Phone:916-772-0112
Practice Address - Fax:916-772-0133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental