Ahmed Al Rawe, DDS

Individual provider Active NPI Dentist · Othello, WA

NPI 1497499339 · NPPES record last updated Dec 1, 2022

Key facts

NPI
1497499339
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
7739 (NV)
Practice address
1515 E Columbia St
Othello, WA 99344-1846
Phone
(509) 488-5256
NPI assigned
Apr 26, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7739NVMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist
Group: 193400000X SINGLE SPECIALTY GROUP
122300000X 7739 NV Yes

Addresses

Primary practice location

1515 E Columbia St
Othello, WA 99344-1846

Mailing address

7401 W Washington Ave Apt 1121
Las Vegas, NV 89128-4310
Phone (402) 805-1790

Other providers in Othello, WA

All providers in Othello, WA · Dentist in Washington

Sources for this page

Verify at the official NPI Registry.