Provider Demographics
NPI:1114571262
Name:AHMED, SAIRA (DMD)
Entity type:Individual
Prefix:DR
First Name:SAIRA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 CORNWALL AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4648
Mailing Address - Country:US
Mailing Address - Phone:370-676-6177
Mailing Address - Fax:360-925-3044
Practice Address - Street 1:1616 CORNWALL AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4648
Practice Address - Country:US
Practice Address - Phone:370-676-6177
Practice Address - Fax:360-925-3044
Is Sole Proprietor?:No
Enumeration Date:2019-07-27
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE610699371223G0001X
IL019.032278122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE.61069937OtherWASHINGTON STATE DEPARTMENT OF HEALTH
IL019.032278OtherDENTAL LICENSE