Healthcare Provider Details
I. General information
NPI: 1538803820
Provider Name (Legal Business Name): AHAD ZARIN SAQIB DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/23/2022
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2965 E CHESTNUT EXPY
SPRINGFIELD MO
65802-2595
US
IV. Provider business mailing address
2706 APPLE VALLEY CIR
OREFIELD PA
18069-2239
US
V. Phone/Fax
- Phone: 417-831-3311
- Fax:
- Phone: 610-554-9322
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DS044012 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 2024028456 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: