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General NPI Number Information
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NPI Number | 1457912040
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Entity Type | Individual
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Provider Name | KASHIF AHMED DMD
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Gender | Male
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 06/24/2019
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Provider Practice Location Address
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Address Line | 19510 VAN BUREN BLVD STE F5
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City | RIVERSIDE
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State | CA
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Zip | 92508-9458
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Country | US
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Telephone | 951-565-4944
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Fax |
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Provider Business Mailing Address
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Address Line | 1583 E LINCOLN AVE
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City | ANAHEIM
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State | CA
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Zip | 92805-2294
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Country | US
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Telephone | 714-600-2875
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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 | 103791
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License Number State | CA
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