Individual provider Active NPI

Hamad Rafiq Ismail Hamad, DDS

  • General Practice Dentistry
  • Scottdale, GA
National Provider Identifier
1760908446
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14066 Issued in NC
Practice address
506 Lantern Wood Dr
Scottdale, GA 30079-1894
Phone
(724) 426-2389
NPI assigned
Aug 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 111542 CA
Dentist 122300000X 1001668 WI
Dentist 122300000X 0401417077 VA
General Practice Dentistry 1223G0001X 2024018541 MO
Dentist 122300000X 019.031991 IL
General Practice Dentistry 1223G0001X 14066 NC Primary
General Practice Dentistry 1223G0001X DN122591 GA
General Practice Dentistry 1223G0001X 1001668 WI

Addresses

Primary practice location

506 Lantern Wood Dr
Scottdale, GA 30079-1894

Mailing address

8010 Arco Corporate Dr Ste 230
Raleigh, NC 27617-2014
Phone (724) 426-2389

Other practice location 1

3212 Hampton Hwy
Yorktown, VA 23693-4948
Phone (757) 209-2786

Other practice location 2

292 Turner St # B
Aberdeen, NC 28315-2363
Phone (910) 807-0071

Other practice location 3

7117 Green Bay Rd
Kenosha, WI 53142-1450
Phone (262) 942-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180223002035 WI Order and Referring Only - DentistPractitioner - Dentist 4587925052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.031991ILMDDentist
0401417077VAMDDentist
DN122591GAMDGeneral Practice Dentistry
1001668WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Associates LTD of Wisconsin General Practice PastSince Feb 14, 2016 Accepting new patients

Organizations & group practices 1

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": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1760908446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 ARCO CORPORATE DR STE 230",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276172014",
            "telephone_number": "724-426-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 LANTERN WOOD DR",
            "city": "SCOTTDALE",
            "state": "GA",
            "postal_code": "300791894",
            "telephone_number": "724-426-2389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3212 Hampton Hwy",
            "address_purpose": "LOCATION",
            "city": "Yorktown",
            "state": "VA",
            "postal_code": "236934948",
            "country_code": "US",
            "telephone_number": "757-209-2786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "292 Turner St # B",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "NC",
            "postal_code": "283152363",
            "country_code": "US",
            "telephone_number": "910-807-0071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7117 Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531421450",
            "country_code": "US",
            "telephone_number": "262-942-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMAD",
        "first_name": "HAMAD",
        "middle_name": "RAFIQ ISMAIL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "111542",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001668",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417077",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2024018541",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031991",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "14066",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122591",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001668",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottdale, GA

Sources for this page

Verify at the official NPI Registry.