MEDICARE: AMMARA GHAFOOR BDS

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	122300000X	Dentist	30.026293	OH
2	122300000X	Dentist	DN26389	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144712589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMMARA GHAFOOR BDS

Provider Business Mailing Address
First Line	:	9218 SAFFRON CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-8065
Country	:	US
Telephone Number	:	917-378-3662
Fax Number	:

Provider Business Practice Location Address
First Line	:	238 SOLANA RD
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-2297
Country	:	US
Telephone Number	:	904-575-3932
Fax Number	:

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

Provider Enumeration Date	:	06/01/2018
Last Update Date	:	09/05/2024

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