Basic Information
| Provider Information | |||||||||
| NPI: | 1164701934 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AHMED | ||||||||
| FirstName: | SYED | ||||||||
| MiddleName: | BILAL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2165 CUNNINGHAM DR | ||||||||
| Address2: | |||||||||
| City: | HAMPTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236662569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7578275665 | ||||||||
| FaxNumber: | 7578963615 | ||||||||
| Practice Location | |||||||||
| Address1: | 2165 CUNNINGHAM DR | ||||||||
| Address2: | |||||||||
| City: | HAMPTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236662569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7578275665 | ||||||||
| FaxNumber: | 7578963615 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2011 | ||||||||
| LastUpdateDate: | 03/29/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 0401413255 | VA | N | Dental Providers | Dentist | 1223G0001X | 0401413255 | VA | Y | Dental Providers | Dentist | General Practice |
No ID Information.