Provider Demographics
NPI:1497908164
Name:RAOUF, RAFIDAIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAFIDAIN
Middle Name:
Last Name:RAOUF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RAFIDAIN
Other - Middle Name:
Other - Last Name:AL-MOUSAWI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:14271 JEFFREY RD.
Mailing Address - Street 2:#252
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620
Mailing Address - Country:US
Mailing Address - Phone:951-768-6099
Mailing Address - Fax:
Practice Address - Street 1:14271 JEFFREY RD
Practice Address - Street 2:#252
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3405
Practice Address - Country:US
Practice Address - Phone:951-768-6099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice