Provider Demographics
NPI:1720812530
Name:AHMAD, FAHAD NAHAYAN (DDS)
Entity type:Individual
Prefix:
First Name:FAHAD
Middle Name:NAHAYAN
Last Name:AHMAD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LEGENDARY CIR
Mailing Address - Street 2:
Mailing Address - City:BRAMPTON
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L6Y 0R9
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6855 MEADOWVALE TOWN CENTRE CIR
Practice Address - Street 2:UNIT # 326
Practice Address - City:MISSISSAUGA
Practice Address - State:ONTARIO
Practice Address - Zip Code:L5N2Y1
Practice Address - Country:CA
Practice Address - Phone:905-813-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0639841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice