Provider Demographics
NPI:1962073759
Name:AHMAD, SOHAIB (DMD)
Entity type:Individual
Prefix:DR
First Name:SOHAIB
Middle Name:
Last Name:AHMAD
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 1:14631 SW 110TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6614
Mailing Address - Country:US
Mailing Address - Phone:786-348-5480
Mailing Address - Fax:
Practice Address - Street 1:1320 CORSICANA HWY STE 160
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-2653
Practice Address - Country:US
Practice Address - Phone:786-348-5480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37272122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist