Healthcare Provider Details

I. General information

NPI: 1427982552
Provider Name (Legal Business Name): C AND A DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 N. BROADWAY SUITE #410
JERICHO NY
11753
US

IV. Provider business mailing address

380 N. BROADWAY SUITE #410
JERICHO NY
11753
US

V. Phone/Fax

Practice location:
  • Phone: 631-889-1864
  • Fax:
Mailing address:
  • Phone: 631-889-1864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: RAHILA AHMED
Title or Position: DENTIST/OWNER-PARTNER
Credential: DDS
Phone: 631-889-1864