MEDICARE: ASSMA SYED AHAMED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	14453	NC

General Provider Information

NPI Number	:	1073354486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASSMA SYED AHAMED

Provider Business Mailing Address
First Line	:	25 FORREST DR
Second Line	:
City	:	PINEHURST
State	:	NC
Zip	:	28374-8041
Country	:	US
Telephone Number	:	949-351-5108
Fax Number	:

Provider Business Practice Location Address
First Line	:	10868 US HIGHWAY 15 501
Second Line	:
City	:	SOUTHERN PINES
State	:	NC
Zip	:	28387-5149
Country	:	US
Telephone Number	:	415-502-5800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2024
Last Update Date	:	09/02/2025

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