Active NPI
Mark M. Dawoud, D.M.D.
- Pediatric Dentistry
- Middletown, NY
National Provider Identifier
1013277037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 058404-1
- Practice address
- 75 Dolson Ave
Middletown, NY 10940-6501 - Phone
- (845) 325-8635
- NPI assigned
- May 23, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN1855943 | MA | |
| Pediatric Dentistry | 1223P0221X | 058404-1 | NY | Primary |
Addresses
Primary practice location
75 Dolson Ave
Middletown, NY 10940-6501
Mailing address
20 Omni Parc Dr
Nanuet, NY 10954-5904
Phone (845) 325-8635
Other practice location 1
444 W Pipkin Rd
Lakeland, FL 33813-2612
Phone (863) 619-6600
Other practice location 2
647 W Lumsden Rd
Brandon, FL 33511-5911
Phone (813) 563-0680
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1855943 | MA | MD | Pediatric Dentist |
| 058404-1 | NY | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Associates of Florida (S. Lakeland) PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Lakeland, FL
- NPI 1316497134
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1013277037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 OMNI PARC DR",
"city": "NANUET",
"state": "NY",
"postal_code": "109545904",
"telephone_number": "845-325-8635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 DOLSON AVE",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109406501",
"telephone_number": "845-325-8635"
}
],
"practiceLocations": [
{
"address_1": "444 W Pipkin Rd",
"address_purpose": "LOCATION",
"city": "Lakeland",
"state": "FL",
"postal_code": "338132612",
"country_code": "US",
"telephone_number": "863-619-6600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "647 W Lumsden Rd",
"address_purpose": "LOCATION",
"city": "Brandon",
"state": "FL",
"postal_code": "335115911",
"country_code": "US",
"telephone_number": "813-563-0680",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAWOUD",
"first_name": "MARK",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-23",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MA",
"license": "DN1855943",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "058404-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.