Individual provider Active NPI

Michael Wagih Awadallah, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Bethlehem, PA
National Provider Identifier
1205273117
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS043980 Issued in PA
Practice address
1521 8TH Ave Ste 101
Bethlehem, PA 18018-1893
Phone
(484) 658-5758
NPI assigned
May 31, 2013
Last updated
Jan 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS043980 PA Primary

Addresses

Primary practice location

1521 8TH Ave Ste 101
Bethlehem, PA 18018-1893

Mailing address

1521 8TH Ave Ste 101
Bethlehem, PA 18018-1893

Other practice location 1

17411 Horace Harding Expy
Fresh Meadows, NY 11365-1527
Phone (718) 670-1060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190701001472 NY Practitioner - Oral SurgeryPractitioner - General SurgeryPractitioner - Plastic and Reconstructive SurgeryPractitioner - Maxillofacial SurgeryPractitioner - Surgical Oncology 3476840323 Reassigns benefits to 2 organizations
I20240307000109 PA Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 3476840323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Columbia University College of Dental Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

1028 N 19TH St
Allentown, PA 18104-3762
Phone (610) 865-8077

801 Ostrm St
Bethlehem, PA 18015-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
New York Queens Medicine and Surgery, P.C. Current Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 1, 2019 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Jan 2, 2024 Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 1, 2019 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Jan 2, 2024 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Aug 26, 2019 Accepting new patients
Cornell University Medical College PastSince Aug 11, 2019 Accepting new patients

Locations

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

17411 Horace Harding Expy
Fresh Meadows, NY 11365
Phone (718) 670-1060

50 E 69th St
New York, NY 10021
Phone (212) 570-4000

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

525 E 68th St
Fl 24
New York, NY 10065
Phone (212) 746-4180

1981 Marcus Ave
Ste 208
North New Hyde Park, NY 11042
Phone (718) 670-1415

1521 8th Ave
Ste 101
Bethlehem, PA 18018

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Interoperability endpoints

  • Direct secure messaging: mawadallah305614@direct-sluhn.org
  • Direct secure messaging: mwa9003@direct.nyp.org

Organizations & group practices 8

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1205273117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 8TH AVE STE 101",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180181893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 8TH AVE STE 101",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180181893",
            "telephone_number": "484-658-5758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17411 Horace Harding Expy",
            "address_purpose": "LOCATION",
            "city": "Fresh Meadows",
            "state": "NY",
            "postal_code": "113651527",
            "country_code": "US",
            "telephone_number": "718-670-1060",
            "fax_number": "718-357-0194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AWADALLAH",
        "first_name": "MICHAEL",
        "middle_name": "WAGIH",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-31",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS043980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.