1699135590 NPI number — DR. AWAD KAMIL BDS,MSC,MFDRCSI

Table of content: DR. AWAD KAMIL BDS,MSC,MFDRCSI (NPI 1699135590)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699135590 NPI number — DR. AWAD KAMIL BDS,MSC,MFDRCSI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAMIL
Provider First Name:
AWAD
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
BDS,MSC,MFDRCSI
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699135590
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4000 NW 51 ST APP B25
Provider Second Line Business Mailing Address:
LACKE CROSSING
Provider Business Mailing Address City Name:
GAINESVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-979-1809
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
43130 AMBERWOOD PLZ STE 230
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH RIDING
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20152-4110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-996-3520
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/04/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  0401415793 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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