Provider Demographics
NPI:1457414567
Name:AHMED, MOHAMED S (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:S
Last Name:AHMED
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 1:200 FORBES ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1538
Mailing Address - Country:US
Mailing Address - Phone:443-603-9000
Mailing Address - Fax:443-603-9010
Practice Address - Street 1:405 FREDERICK RD
Practice Address - Street 2:SUITE 150
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4645
Practice Address - Country:US
Practice Address - Phone:410-747-0077
Practice Address - Fax:410-744-3135
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12501122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist