MEDICARE: DR. AMEERA Y AHMAD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401412317	VA

General Provider Information

NPI Number	:	1346556073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMEERA Y AHMAD DDS

Provider Business Mailing Address
First Line	:	1090 NORTHCHASE PKWY SE
Second Line	:	SUITE 290
City	:	MARIETTA
State	:	GA
Zip	:	30067-6405
Country	:	US
Telephone Number	:	678-904-5665
Fax Number	:

Provider Business Practice Location Address
First Line	:	5900 E VIRGINIA BEACH BLVD
Second Line	:	SUITE 70
City	:	NORFOLK
State	:	VA
Zip	:	23502-2473
Country	:	US
Telephone Number	:	757-466-3622
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2010
Last Update Date	:	08/18/2010

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