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NPI Code Detail

MEDICARE: AHMED A ELBIRA DDS

MEDICARE: AHMED A ELBIRA 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
1390200000XStudent in an Organized Health Care Education/Training ProgramTX
21223X0400XOrthodontics and Dentofacial Orthopedics Dentistry40038TX

General Provider Information

NPI Number : 1598441685
Entity Type Code : Individual
Provider Name (Legal Business Name) : AHMED A ELBIRA DDS
Provider Business Mailing Address
First Line : 9745 TOUCHTON RD UNIT 923
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-4496
Country : US
Telephone Number : 631-992-5852
Fax Number :
Provider Business Practice Location Address
First Line : 2539 JUDSON RD
Second Line :
City : LONGVIEW
State : TX
Zip : 75605-4643
Country : US
Telephone Number : 903-402-1708
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2023
Last Update Date : 04/07/2026

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Directions to “ AHMED A ELBIRA DDS” Practice Location

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