Provider Demographics
NPI:1831263284
Name:AKHTER, MAHAM IJAZ (DMD)
Entity type:Individual
Prefix:DR
First Name:MAHAM
Middle Name:IJAZ
Last Name:AKHTER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 TIMBER HITCH RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8743
Mailing Address - Country:US
Mailing Address - Phone:919-386-8082
Mailing Address - Fax:
Practice Address - Street 1:6320 CAPITAL BLVD
Practice Address - Street 2:SUITE 121
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2989
Practice Address - Country:US
Practice Address - Phone:919-981-7363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8278122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist