Provider Demographics
NPI:1700903622
Name:AKHTAR, SYED FARID (DDS)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:FARID
Last Name:AKHTAR
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 1:2664 CASTLE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-0213
Mailing Address - Country:US
Mailing Address - Phone:914-563-6233
Mailing Address - Fax:
Practice Address - Street 1:8105 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-2028
Practice Address - Country:US
Practice Address - Phone:510-568-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-24
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA531891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice