Healthcare Provider Details

I. General information

NPI: 1407741176
Provider Name (Legal Business Name): NOURAH ABDUL KADER, DMD, MS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 SAN PABLO AVE
ALBANY CA
94706-1126
US

IV. Provider business mailing address

591 SAN PABLO AVE
ALBANY CA
94706-1126
US

V. Phone/Fax

Practice location:
  • Phone: 313-447-9606
  • Fax:
Mailing address:
  • Phone: 313-447-9606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. NOURAH ABDUL KADER
Title or Position: ORTHODONTIST/OWNER
Credential: DMD, MS
Phone: 313-447-9606