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MR. RAED AL AJLOUNI DDS
NPI 1356577795
Dentist in Southlake, TX

Active since May 29, 2009Opted out of Medicare · through Apr 19, 2028
100 W. SOUTHLAKE BLVD., STE 146, SOUTHLAKE, TX 76092(817) 251-9333(817) 251-9320 Get Directions Write a Review

NPPES record last updated: June 8, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Raed Al Ajlouni Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RAED AL AJLOUNI DDS (NPI 1356577795) is an individual dentist in Southlake, Texas, licensed in Texas (21791) and active in the NPI registry since May 2009. He has opted out of Medicare through April 19, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1356577795
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameMR. RAED AL AJLOUNICredential: DDS
Location Address100 W. SOUTHLAKE BLVD., STE 146Southlake, TX 76092
Mailing Address100 W. Southlake Blvd., Ste 146Southlake, TX 76092 · (817) 251-9333 · Fax (817) 251-9320
Phone(817) 251-9333
Fax(817) 251-9320
Sole ProprietorYes
Enumeration DateMay 29, 2009
Last NPPES UpdateJune 8, 2009
✔ NPI 1356577795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in TX · 21791
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
100 W. SOUTHLAKE BLVD., Southlake, TX 76092
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Guardian, Humana.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Mr. Raed Al Ajlouni Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 19, 2016 through April 19, 2028.

Opt-Out Effective DateApril 19, 2016
Opt-Out In Effect ThroughApril 19, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76092 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raed Al Ajlouni's NPI number?

The NPI number for Raed Al Ajlouni is 1356577795. It was assigned to this individual provider in the NPPES registry on May 29, 2009.

Where is Raed Al Ajlouni located?

Raed Al Ajlouni practices at 100 W. Southlake Blvd. Ste 146, Southlake, TX 76092. The listed phone number is (817) 251-9333.

What is Raed Al Ajlouni's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Raed Al Ajlouni enrolled in Medicare?

No. Raed Al Ajlouni has opted out of Medicare through April 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Raed Al Ajlouni accept?

Health plans from Guardian and Humana list Raed Al Ajlouni as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Raed Al Ajlouni was last updated on June 8, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.