Provider Demographics
NPI:1912473190
Name:ATARCHI, AHMED RAMZI
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:RAMZI
Last Name:ATARCHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2387 S GREEN RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1479
Mailing Address - Country:US
Mailing Address - Phone:314-793-6818
Mailing Address - Fax:
Practice Address - Street 1:6315 PEARL RD
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3082
Practice Address - Country:US
Practice Address - Phone:440-842-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-16
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401416285122300000X
OH30.0256061223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist