Provider Demographics
NPI:1366284895
Name:ELAMIN, AHMED MOHAMED AHMED MOHAME (DMD)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:MOHAMED AHMED MOHAME
Last Name:ELAMIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9820 SW FREWING ST APT 27
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5064
Mailing Address - Country:US
Mailing Address - Phone:503-758-5607
Mailing Address - Fax:
Practice Address - Street 1:9820 SW FREWING ST APT 27
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-5064
Practice Address - Country:US
Practice Address - Phone:503-758-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program