Provider Demographics
NPI:1851429013
Name:READE, IRA FRANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:FRANK
Last Name:READE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3711 UNIVERSITY DR STE D
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2654
Mailing Address - Country:US
Mailing Address - Phone:919-493-6926
Mailing Address - Fax:
Practice Address - Street 1:3711 UNIVERSITY DR STE D
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2654
Practice Address - Country:US
Practice Address - Phone:919-493-6926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC49401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
755743OtherTRICARE INDENTIFICATION
NC7997286Medicaid
NC97286OtherBLUE CROSS BLUE SHIELD ID
NC97286OtherBLUE CROSS BLUE SHIELD ID