Healthcare Provider Details

I. General information

NPI: 1447193826
Provider Name (Legal Business Name): AHMED ZAGHLOUL BAYOUMY ALY HUSSEIN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3635 N FREEWAY BLVD STE 110
SACRAMENTO CA
95834-2926
US

IV. Provider business mailing address

2246 GATEWAY OAKS DR APT 305
SACRAMENTO CA
95833-3222
US

V. Phone/Fax

Practice location:
  • Phone: 916-285-6691
  • Fax:
Mailing address:
  • Phone: 916-317-9177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113330
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: