Iyad Samir Awadallah, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.028905 Issued in IL

Practice address

219 N Hammes Ave Ste 3
Joliet, IL 60435-8145

Phone

(815) 725-7900

NPI assigned

Jun 10, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Iyad Awadallah DMD PC

  • General Practice Dentistry
  • Joliet, IL
  • NPI 1669127247
  NPD Authorized official
• Alaa Alwazzan DMD PC

  • Prosthodontics
  • Quincy, MA
  • NPI 1710218425

  General Practice

  NPD (past)
• Quincy Dental Specialists Group LLC

  • General Practice Dentistry
  • Quincy, MA
  • NPI 1811542400
  NPD (past)

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644710400000",
    "number": "1124313838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8697 SCHEER DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604878660",
            "telephone_number": "605-553-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N HAMMES AVE STE 3",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358145",
            "telephone_number": "815-725-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1431 S Woodland Ave",
            "address_purpose": "LOCATION",
            "city": "Michigan City",
            "state": "IN",
            "postal_code": "463607122",
            "country_code": "US",
            "telephone_number": "219-531-9293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AWADALLAH",
        "first_name": "IYAD",
        "middle_name": "SAMIR",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2022-02-13",
        "certification_date": "2022-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012053A",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.028905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeshona Iman Averett Butler
• Avid Dental
• Avid Dental PC
• Avila Caregiver Services LLC
• Guadalupe Avila
• Stella Yaa Awua-Larbi, M.D.
• Tayaba Nada Azher, MD
• George F Aziz, M.D.
• Joyce Azzaline, APRN-BC, DHSC
• James John Babiuk, D.D.S.

• General Practice Dentistry in Joliet, IL
• Providers in Joliet, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.

Verify at the official NPI Registry.