1366284895 NPI number — DR. AHMED MOHAMED AHMED MOHAME ELAMIN DMD

Table of content: ERIKA JOLDRICHSEN PA-C (NPI 1992466056)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366284895 NPI number — DR. AHMED MOHAMED AHMED MOHAME ELAMIN DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ELAMIN
Provider First Name:
AHMED
Provider Middle Name:
MOHAMED AHMED MOHAME
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366284895
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9820 SW FREWING ST APT 27
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TIGARD
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97223-5064
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-758-5607
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13175 SW RAPTOR PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TIGARD
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97223-2872
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-758-5607
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  D12117 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com