Provider Demographics
NPI:1174356992
Name:AHMAD, YASMEEN
Entity type:Individual
Prefix:
First Name:YASMEEN
Middle Name:
Last Name:AHMAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 S 58TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-4937
Mailing Address - Country:US
Mailing Address - Phone:414-499-1270
Mailing Address - Fax:
Practice Address - Street 1:1251B SARATOGA AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1025
Practice Address - Country:US
Practice Address - Phone:202-469-4699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND151871223G0001X
DCDEN20004231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice