Provider Demographics
NPI:1073354486
Name:SYED AHAMED, ASSMA
Entity type:Individual
Prefix:
First Name:ASSMA
Middle Name:
Last Name:SYED AHAMED
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 1:25 FORREST DR
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8041
Mailing Address - Country:US
Mailing Address - Phone:949-351-5108
Mailing Address - Fax:
Practice Address - Street 1:10868 US HIGHWAY 15 501
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-5149
Practice Address - Country:US
Practice Address - Phone:415-502-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC144531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice