Healthcare Provider Details

I. General information

NPI: 1346127545
Provider Name (Legal Business Name): RAGHAD OSAMA HAMMAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 08/19/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 NEWTON RD
IOWA CITY IA
52242-8004
US

IV. Provider business mailing address

435 S LINN ST APT 1225
IOWA CITY IA
52240-4999
US

V. Phone/Fax

Practice location:
  • Phone: 319-335-7499
  • Fax:
Mailing address:
  • Phone: 202-203-0771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberRES-30730
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: