Provider Demographics
NPI:1588320659
Name:AHMAD, RASHA (DMD)
Entity type:Individual
Prefix:
First Name:RASHA
Middle Name:
Last Name:AHMAD
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 1:22922 N 40TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-8742
Mailing Address - Country:US
Mailing Address - Phone:347-939-7334
Mailing Address - Fax:
Practice Address - Street 1:22922 N 40TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-8742
Practice Address - Country:US
Practice Address - Phone:347-939-7334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD011227122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist