Individual provider Active NPI

Antonious Dawood, DMD

  • General Practice Dentistry
  • Westminster, CA
National Provider Identifier
1164917092
Registry record updated Jan 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
102541 Issued in CA
Practice address
6462 Westminster Blvd
Westminster, CA 92683-3601
Phone
(714) 898-8728
NPI assigned
Jun 23, 2018
Last updated
Jan 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 102541 CA Primary

Addresses

Primary practice location

6462 Westminster Blvd
Westminster, CA 92683-3601

Mailing address

6462 Westminster Blvd
Westminster, CA 92683-3601
Phone (714) 898-8728

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
102541CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Philo Smile General Practice CurrentSince Jan 24, 2021 Accepting new patients
Antonious Dawood DMD Corp General Practice CurrentSince Jan 24, 2021 Accepting new patients

Locations

6462 Westminster Blvd
Westminster, CA 92683
Phone (714) 898-8728

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610841600000",
    "number": "1164917092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6462 WESTMINSTER BLVD",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926833601",
            "telephone_number": "714-898-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6462 WESTMINSTER BLVD",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926833601",
            "telephone_number": "714-898-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWOOD",
        "first_name": "ANTONIOUS",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-23",
        "last_updated": "2021-01-17",
        "certification_date": "2021-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2021; 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.