Provider Demographics
NPI:1215812482
Name:MAHMUD, ADEM GEMAL (DDS)
Entity type:Individual
Prefix:
First Name:ADEM
Middle Name:GEMAL
Last Name:MAHMUD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 TROW ST
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-8769
Mailing Address - Country:US
Mailing Address - Phone:610-731-3499
Mailing Address - Fax:
Practice Address - Street 1:17 WATERFORD DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-8266
Practice Address - Country:US
Practice Address - Phone:717-551-1584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0453371223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics