Rana Azhan Ahmad, DDS
Individual provider Active NPI Dentist · Trenton, FL
NPI 1750124335 · NPPES record last updated Jan 15, 2025
Key facts
- NPI
- 1750124335
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN29015 (FL)
- Practice address
- 911 S Main St
Trenton, FL 32693-3239 - Phone
- (352) 463-4526
- Fax
- (352) 463-6271
- NPI assigned
- Jun 13, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240919000989 | FL | Order and Referring Only - Dentist |
3971044801 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN29015 | FL | MD | Dentist |
Networks
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN29015 | FL | Yes |
Addresses
Primary practice location
911 S Main St
Trenton, FL 32693-3239
Mailing address
23476 NW 186TH Ave
High Springs, FL 32643-0673
Phone (386) 454-0698
Other providers in Trenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.