Healthcare Provider Details

I. General information

NPI: 1588644793
Provider Name (Legal Business Name): ZAHEER CHAUDHRY D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 RITTENHOUSE PL
ARDMORE PA
19003-2209
US

IV. Provider business mailing address

7 RITTENHOUSE PL
ARDMORE PA
19003-2209
US

V. Phone/Fax

Practice location:
  • Phone: 610-642-6391
  • Fax: 610-649-9048
Mailing address:
  • Phone: 610-642-6391
  • Fax: 610-649-9048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS020220L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: