Provider Demographics
NPI:1124643242
Name:TAHA, GEHAD (DMD)
Entity type:Individual
Prefix:
First Name:GEHAD
Middle Name:
Last Name:TAHA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431 BECK DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2661
Mailing Address - Country:US
Mailing Address - Phone:630-518-0985
Mailing Address - Fax:
Practice Address - Street 1:901 W 15TH ST STE A
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-8880
Practice Address - Country:US
Practice Address - Phone:972-403-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX383371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice