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General NPI Number Information
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NPI Number | 1396024287
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Entity Type | Organization
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Legal Business Name | MAHIN AHMADI DDS
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 1105 E JAMES ST
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City | BAYTOWN
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State | TX
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Zip | 77520-5821
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Country | US
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Telephone | 281-422-8268
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Fax | 281-837-6100
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Provider Business Mailing Address
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Address Line | 1105 E JAMES ST
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City | BAYTOWN
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State | TX
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Zip | 77520-5821
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Country | US
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Telephone | 281-422-8268
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Fax | 281-837-6100
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAHIN AHMADI
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Credential | D.D.S.
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Telephone | 281-422-8268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 25536
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 25109
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 25257
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19145
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License Number State | TX
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