Provider Demographics
NPI:1023284858
Name:ABDOLLAHI, AHMAD R (DMD)
Entity type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:R
Last Name:ABDOLLAHI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:AFSHIN
Other - Middle Name:
Other - Last Name:ABDOLLAHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:285 SOUTH DRIVE
Mailing Address - Street 2:#2
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040
Mailing Address - Country:US
Mailing Address - Phone:650-988-0787
Mailing Address - Fax:650-988-0733
Practice Address - Street 1:285 SOUTH DRIVE
Practice Address - Street 2:#2
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040
Practice Address - Country:US
Practice Address - Phone:650-988-0787
Practice Address - Fax:650-988-0733
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB39739122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist