Provider Demographics
NPI:1982796728
Name:EID, AHMED M (DDS)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:M
Last Name:EID
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 1:1655 ELMWOOD AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3426
Mailing Address - Country:US
Mailing Address - Phone:585-271-5811
Mailing Address - Fax:585-271-6268
Practice Address - Street 1:1655 ELMWOOD AVE STE 115
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3426
Practice Address - Country:US
Practice Address - Phone:585-271-5811
Practice Address - Fax:585-271-6268
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046268122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02199902Medicaid