Individual
DR. AZMA AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
12750 SE STARK ST BLDG E, PORTLAND, OR 97233-1539
(971) 347-3009
(971) 256-3277
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
33934
TX
122300000X
Dentist
Primary
D10191
OR
122300000X
Dentist
DE60540896
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2073790
—
WA
05
—
500696873
—
OR
Enumeration date
03/23/2015
Last updated
11/17/2020
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