Omar Al Azzawi, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12014066A Issued in IN

Practice address

1537 S Scatterfield Rd Ste a
Anderson, IN 46016-5783

Phone

(765) 347-7722

NPI assigned

May 22, 2023

Last updated

Apr 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712361600000",
    "number": "1104518083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17132 SEABOARD PL",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460620125",
            "telephone_number": "347-327-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 S SCATTERFIELD RD STE A",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460165783",
            "telephone_number": "765-347-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL AZZAWI",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2024-04-06",
        "certification_date": "2024-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014066A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Usman Ahmad, M.D.
• Brandon Aiman, PA
• Richard Y Aina, MD
• Olugbenga David Akinmosin
• Mida Akiti, FNP-C
• Hadeel Khaled Othman Al Fares
• Ahmed F Al Jebawi, MD
• Rami Ibrahim Al Mais
• Ravindrakumar Alagugurusamy, M.D.
• Albert W. Happel, OD, PC (Anderson Vision care)

• Dentist in Anderson, IN
• Providers in Anderson, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.