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General NPI Number Information
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NPI Number | 1104049303
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Entity Type | Individual
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Provider Name | BEHSHAD AHKAMI DDS
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 529 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-3229
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Country | US
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Telephone | 973-777-6363
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Fax | 973-473-4100
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Provider Business Mailing Address
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Address Line | 109 HICKORY HILL BLVD
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City | TOTOWA
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State | NJ
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Zip | 07512-2193
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DI020826
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License Number State | NJ
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