Provider Demographics
NPI:1962819086
Name:RAAD, JENNIFER H (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:H
Last Name:RAAD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 MCKINNEY AVE APT 1504
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3081
Mailing Address - Country:US
Mailing Address - Phone:214-236-5759
Mailing Address - Fax:
Practice Address - Street 1:2700 BROWN TRL STE 1
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4182
Practice Address - Country:US
Practice Address - Phone:817-282-1331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX301031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice