Provider Demographics
NPI:1831750678
Name:ALDARAGI, RAAD (DDS)
Entity type:Individual
Prefix:DR
First Name:RAAD
Middle Name:
Last Name:ALDARAGI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 EMPIRE DR APT 6321
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-0081
Mailing Address - Country:US
Mailing Address - Phone:317-400-5096
Mailing Address - Fax:
Practice Address - Street 1:10325 LAKE JUNE RD STE 700
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-5320
Practice Address - Country:US
Practice Address - Phone:469-533-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35191122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE