Healthcare Provider Details

I. General information

NPI: 1053310730
Provider Name (Legal Business Name): RICHARD G. RAAD DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28050 HARPER AVE
SAINT CLAIR SHORES MI
48081-1562
US

IV. Provider business mailing address

28050 HARPER AVE
SAINT CLAIR SHORES MI
48081-1562
US

V. Phone/Fax

Practice location:
  • Phone: 586-774-6655
  • Fax:
Mailing address:
  • Phone: 586-530-0689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901013803
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: