Provider Demographics
NPI:1962819086
Name:RAAD, JENNIFER H (DDS, MDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:H
Last Name:RAAD
Suffix:
Gender:F
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 PRESTON RD STE 375
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6221
Mailing Address - Country:US
Mailing Address - Phone:214-361-6669
Mailing Address - Fax:
Practice Address - Street 1:8201 PRESTON RD STE 375
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6221
Practice Address - Country:US
Practice Address - Phone:214-361-6669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX301031223G0001X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice