Healthcare Provider Details

I. General information

NPI: 1356775696
Provider Name (Legal Business Name): SAHER AHMED DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2990 MILITARY AVE
BAXTER SPRINGS KS
66713-2331
US

IV. Provider business mailing address

3011 N MICHIGAN ST
PITTSBURG KS
66762-2546
US

V. Phone/Fax

Practice location:
  • Phone: 620-856-2900
  • Fax: 620-856-2901
Mailing address:
  • Phone: 620-231-9873
  • Fax: 620-231-2808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number61074
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: