Provider Demographics
NPI:1982096798
Name:M H AHMED DMD LLC
Entity Type:Organization
Organization Name:M H AHMED DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:804-270-9989
Mailing Address - Street 1:9840 W BROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-4199
Mailing Address - Country:US
Mailing Address - Phone:804-270-9989
Mailing Address - Fax:804-270-9296
Practice Address - Street 1:9840 W BROAD ST STE B
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-4199
Practice Address - Country:US
Practice Address - Phone:804-270-9989
Practice Address - Fax:804-270-9296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
122300000X
VA0401411318302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance Organization