Rahaf Kanawati Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RAHAF KANAWATI DENTAL PC

Doing business as

Portage Dental office

Practice address

6505 Constitution Blvd Ste B
Portage, MI 49024-1605

Phone

(269) 276-6602

NPI assigned

Jan 29, 2024

Organization subpart

No

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

Authorized official

Name

Rahaf Kanawati

Title

Owner

Phone

(269) 276-6602

Specialties & licenses 1

Addresses

Other names 1

• Portage Dental office Doing business as

Locations

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1336901826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 CONSTITUTION BLVD STE B",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490241605",
            "telephone_number": "269-276-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 CONSTITUTION BLVD STE B",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490241605",
            "telephone_number": "269-276-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAHAF KANAWATI DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "KANAWATI",
        "authorized_official_first_name": "RAHAF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-276-6602"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portage Dental office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Quertermus, CRNA
• Derek James Quinn, PHARM.D., R.PH.
• Timothy Lewis Radabaugh, MA, LLP
• Sarah Radke
• Douglas John Raedy, D.O
• Alyssa Ramsey
• Jason Randall, PSYD
• Ryan Michael Ranger, LLMSW
• Annie Rose Rashes
• Heather Ratliff, R.N.

• Dental Clinic/Center in Portage, MI
• Providers in Portage, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.