Provider Demographics
NPI:1861564882
Name:AHSAN, SONIA SADDAF (DDS)
Entity type:Individual
Prefix:DR
First Name:SONIA
Middle Name:SADDAF
Last Name:AHSAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SONIA
Other - Middle Name:SADDAF
Other - Last Name:GONDAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1508 ARCOLA CT
Mailing Address - Street 2:#5
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2701
Mailing Address - Country:US
Mailing Address - Phone:410-535-0296
Mailing Address - Fax:
Practice Address - Street 1:205 STEEPLE CHASE DR
Practice Address - Street 2:STE. 208
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4053
Practice Address - Country:US
Practice Address - Phone:413-535-0296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14336122300000X
MA21861122300000X
VA0401412354122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist