Healthcare Provider Details

I. General information

NPI: 1700571619
Provider Name (Legal Business Name): UMAIR AHMED BDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N STONEWALL AVE
OKLAHOMA CITY OK
73117-1214
US

IV. Provider business mailing address

1201 N STONEWALL AVE
OKLAHOMA CITY OK
73117-1214
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-6056
  • Fax:
Mailing address:
  • Phone: 405-271-6056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License NumberS197
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: