Healthcare Provider Details

I. General information

NPI: 1942474077
Provider Name (Legal Business Name): WAHEED V MOHAMED DDS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2008
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 BILLINGSLEY RD. SUITE 105
CHARLOTTE NC
28211
US

IV. Provider business mailing address

411 BILLINGSLEY RD. SUITE 105
CHARLOTTE NC
28211
US

V. Phone/Fax

Practice location:
  • Phone: 704-347-3900
  • Fax: 704-347-0133
Mailing address:
  • Phone: 704-347-3900
  • Fax: 704-347-0133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number5773
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number201301211
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number10784
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number2013-01211
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: