Individual provider Active NPI

Ahmad Oubaid, DMD

  • Endodontics
  • Lacey, WA
National Provider Identifier
1194487959
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DE61537989 Issued in WA
Practice address
4550 3Rd Ave SE
Lacey, WA 98503-1033
Phone
(855) 433-6825
NPI assigned
Oct 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DE61537989 WA Primary
Endodontics 1223E0200X DN10000766 MA
Dentist 122300000X D11549 OR

Addresses

Primary practice location

4550 3Rd Ave SE
Lacey, WA 98503-1033

Mailing address

4550 3Rd Ave SE
Lacey, WA 98503-1033
Phone (855) 433-6825

Other practice location 1

443 NW Burnside Rd
Gresham, OR 97030-3714
Phone (503) 492-8487

Other practice location 2

200 5th Ave Fl 3
Waltham, MA 02451-8759
Phone (781) 647-0772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240808004660 WA Order and Referring Only - DentistPractitioner - Dentist 4587101449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D11549ORMDDentist
DN10000766MAMDEndodontist
DE61537989WAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Oubaid Endodontic PLLC Endodontics Current Accepting new patients
Willamette Dental Group, P.C. Dentist PastSince Aug 4, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1194487959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 3RD AVE SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031033",
            "telephone_number": "855-433-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 3RD AVE SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031033",
            "telephone_number": "855-433-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "443 NW Burnside Rd",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970303714",
            "country_code": "US",
            "telephone_number": "503-492-8487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 5th Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Waltham",
            "state": "MA",
            "postal_code": "024518759",
            "country_code": "US",
            "telephone_number": "781-647-0772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OUBAID",
        "first_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE61537989",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "DN10000766",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11549",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.