Provider Demographics
NPI:1598334724
Name:AHMADI, BOBBY JARRETT (DMD)
Entity type:Individual
Prefix:DR
First Name:BOBBY
Middle Name:JARRETT
Last Name:AHMADI
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 1:75 THORPE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5724
Mailing Address - Country:US
Mailing Address - Phone:203-231-1217
Mailing Address - Fax:
Practice Address - Street 1:722 POST RD STE 301
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4731
Practice Address - Country:US
Practice Address - Phone:203-656-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13168122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist