Provider Demographics
NPI:1700688025
Name:ABUL-KHOUDOUD, RIAD HASSAN (DMD)
Entity type:Individual
Prefix:
First Name:RIAD
Middle Name:HASSAN
Last Name:ABUL-KHOUDOUD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 WINDEMERE DRIVE
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:KY
Mailing Address - Zip Code:41169
Mailing Address - Country:US
Mailing Address - Phone:606-923-4515
Mailing Address - Fax:
Practice Address - Street 1:2019 HUGHES DR. JOBST TOWER, 6TH FLOOR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606
Practice Address - Country:US
Practice Address - Phone:419-291-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program