Healthcare Provider Details

I. General information

NPI: 1225956949
Provider Name (Legal Business Name): RAND KADDOU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7386 SHAWNEE RD APT 1
N TONAWANDA NY
14120-1395
US

IV. Provider business mailing address

7386 SHAWNEE RD APT 1
N TONAWANDA NY
14120-1395
US

V. Phone/Fax

Practice location:
  • Phone: 248-839-8060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42382
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: