Individual provider Active NPI

Dana Mahmoud Awad, DDS

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1265729875
Registry record updated Jul 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011629A Issued in IN
Practice address
3658 S East St
Indianapolis, IN 46227-1239
Phone
(317) 781-5667
NPI assigned
Jul 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12011629A IN Primary
Pediatric Dentistry 1223P0221X 12011629A IN

Addresses

Primary practice location

3658 S East St
Indianapolis, IN 46227-1239

Mailing address

15399 Gallow LN
Noblesville, IN 46060-4633
Phone (317) 654-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150317001061 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2365769148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011629AINMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
East 53Rd Street Dental-1, PC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1309651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309651200000",
    "number": "1265729875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15399 GALLOW LN",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604633",
            "telephone_number": "317-654-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3658 S EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271239",
            "telephone_number": "317-781-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWAD",
        "first_name": "DANA",
        "middle_name": "MAHMOUD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-03",
        "last_updated": "2011-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011629A",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12011629A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.