Provider Demographics
NPI:1679308522
Name:AHMED, IQRA IDREES (DMD)
Entity type:Individual
Prefix:DR
First Name:IQRA
Middle Name:IDREES
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 1:12 SCHMIDTS PL
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-4133
Mailing Address - Country:US
Mailing Address - Phone:201-850-3612
Mailing Address - Fax:
Practice Address - Street 1:220 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:DUNELLEN
Practice Address - State:NJ
Practice Address - Zip Code:08812-1246
Practice Address - Country:US
Practice Address - Phone:732-624-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI030628001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice