Provider Demographics
NPI:1962962894
Name:OSMAN, AHMED MOHAMED (DDS)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:MOHAMED
Last Name:OSMAN
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 1:529 WHITON RD
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08853-4226
Mailing Address - Country:US
Mailing Address - Phone:973-393-0619
Mailing Address - Fax:908-369-0213
Practice Address - Street 1:530 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2669
Practice Address - Country:US
Practice Address - Phone:908-409-0273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02784700122300000X
NJ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program