Healthcare Provider Details

I. General information

NPI: 1588407126
Provider Name (Legal Business Name): MUHAMMAD ABDULWAHEED QUADRI BDS, AEGD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 EASTGATE SOUTH DR STE 480
CINCINNATI OH
45245-1871
US

IV. Provider business mailing address

950 SOMERSET ST UNIT 201
CINCINNATI OH
45245-3612
US

V. Phone/Fax

Practice location:
  • Phone: 551-525-3222
  • Fax:
Mailing address:
  • Phone: 516-737-5924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.028678
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: