Healthcare Provider Details

I. General information

NPI: 1437599115
Provider Name (Legal Business Name): AHMED ELKADY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

697 POQUONOCK AVE
WINDSOR CT
06095-2249
US

IV. Provider business mailing address

2389 MAIN ST
GLASTONBURY CT
06033-4617
US

V. Phone/Fax

Practice location:
  • Phone: 860-598-0001
  • Fax:
Mailing address:
  • Phone: 860-598-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number12793
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE60364057
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: