Provider Demographics
NPI:1932817491
Name:DAHSHAN, AYHAM (DMD)
Entity type:Individual
Prefix:
First Name:AYHAM
Middle Name:
Last Name:DAHSHAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10501 W 113TH ST APT 5339
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2560
Mailing Address - Country:US
Mailing Address - Phone:708-737-6620
Mailing Address - Fax:
Practice Address - Street 1:8600 WARD PKWY STE 2130
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2607
Practice Address - Country:US
Practice Address - Phone:816-631-1791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS62174122300000X
IL019.033785122300000X
MO20240284571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty