Provider Demographics
NPI:1942056221
Name:AHMEDO DENTAL INC.
Entity type:Organization
Organization Name:AHMEDO DENTAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:M BASHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMEDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-667-3330
Mailing Address - Street 1:6280 JACKSON DR STE 2
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-3436
Mailing Address - Country:US
Mailing Address - Phone:619-667-3330
Mailing Address - Fax:619-667-3337
Practice Address - Street 1:6280 JACKSON DR STE 2
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-3436
Practice Address - Country:US
Practice Address - Phone:619-667-3330
Practice Address - Fax:619-667-3337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist