Healthcare Provider Details

I. General information

NPI: 1285780833
Provider Name (Legal Business Name): AHMED K COLLINS D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6231 S CENTRAL AVE
PHOENIX AZ
85042-4236
US

IV. Provider business mailing address

6231 S CENTRAL AVE
PHOENIX AZ
85042-4236
US

V. Phone/Fax

Practice location:
  • Phone: 973-698-4234
  • Fax: 480-300-5526
Mailing address:
  • Phone: 973-698-4234
  • Fax: 480-300-5526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD7130
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13168
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: