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General NPI Number Information
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NPI Number | 1902951064
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Entity Type | Individual
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Provider Name | DEAN NADEEM AHMAD DDS
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 580 N SUNRISE AVE STE 190
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City | ROSEVILLE
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State | CA
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Zip | 95661-3035
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Country | US
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Telephone | 916-770-9034
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Fax | 916-772-0133
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Provider Business Mailing Address
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Address Line | 2049 CULVERHILL WAY
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City | ROSEVILLE
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State | CA
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Zip | 95747-8805
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Country | US
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Telephone | 916-770-9034
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Fax | 916-434-5575
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 52964
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License Number State | CA
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