Abdalrahman Tawakol, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN28696 Issued in FL

Practice address

4906 US-90
Pace, FL 32571

Phone

(850) 308-1600

NPI assigned

Feb 14, 2024

Last updated

Oct 4, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1205691771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 WETHERBY RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325345620",
            "telephone_number": "850-774-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4906 US-90",
            "city": "PACE",
            "state": "FL",
            "postal_code": "32571",
            "telephone_number": "850-308-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWAKOL",
        "first_name": "ABDALRAHMAN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Pace, FL
• Providers in Pace, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.