Healthcare Provider Details

I. General information

NPI: 1538846647
Provider Name (Legal Business Name): MOTASEM RATEB ALBAGHDADI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 E SUNSET RD STE 100
HENDERSON NV
89014-2238
US

IV. Provider business mailing address

4301 E SUNSET RD STE 100
HENDERSON NV
89014-2238
US

V. Phone/Fax

Practice location:
  • Phone: 702-465-8187
  • Fax: 702-425-9486
Mailing address:
  • Phone: 702-465-8187
  • Fax: 702-425-9486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8398
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: