Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1134747603 Individual Practitioner Male Practitioner

Ahmed Bashir Raddad

Dentist • Connell, WA

Professional Overview & Biography Verified Profile Summary

Ahmed Raddad is a registered healthcare professional specializing in Dentist in Connell, WA. Practice services are available at 1051 COLUMBIA AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1051 Columbia Ave

Connell, WA 993268702

Telephone 5094885256
Fax 5094889939
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Connell, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.1 Yrs
Regional Practice Density
3 Specialists

Practicing in Connell, WA (2853 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-02
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License WA DE61188502

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Secondary Practice Locations

100 E Newton St # 707a

Boston, MA 021183552

Phone: 6173588360

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Laura Ely

Nurse Practitioner - Family

NPI 1003263872

Doctor of Dental Surgery

Mikayla Alonzo , RDH

Dental Hygienist

NPI 1003593294

Registered Dental Hygienist

Dr. Ji Choi , DDS

Dentist - General Practice

NPI 1023165065

Doctor of Dental Surgery

Dr. Randel Bunch , MD

Family Medicine

NPI 1033296637

Doctor of Medicine (M.D.)

NPI 1033768957

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location October 02, 2024

Registered at 1051 COLUMBIA AVE, CONNELL, WA 993268702 (Tel: 5094885256)

📍
Updated Business Mailing Address October 02, 2024

Registered at 1515 E COLUMBIA ST, OTHELLO, WA 993441846 (Tel: 5094885256)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 02, 2024

Dentist (License #DE61188502 in WA)

NPI Profile Active July 10, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location July 10, 2020

Registered at 100 E NEWTON ST # 707A, BOSTON, MA 021183552 (Tel: 6173588360)

📍
Updated Business Mailing Address July 10, 2020

Registered at 100 E NEWTON ST # 707A, BOSTON, MA 021183552 (Tel: 6173588360)

👤
Provider Name / Credentials Updated July 10, 2020

Recorded as AHMED RADDAD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 10, 2020

Dentist (License #DL14238 in MA)

🟢
Initial NPI Registration & Enumeration July 10, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1134747603
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 10, 2020
Last Update: October 02, 2024
Sole Proprietor: No

Mailing Address

1515 E Columbia St

Othello, WA 993441846

Phone: 5094885256

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.