Healthcare Provider Details

I. General information

NPI: 1477256451
Provider Name (Legal Business Name): ZAID TAUHIDUR RAHMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1795 MAIN ST STE 212
SPRINGFIELD MA
01103-1041
US

IV. Provider business mailing address

1795 MAIN ST STE 212
SPRINGFIELD MA
01103-1041
US

V. Phone/Fax

Practice location:
  • Phone: 774-490-9099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10001379
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: