Fadi Al Farawati, DDS, MS, MCLINDENT
Individual provider Active NPI Prosthodontics · Augusta, GA
NPI 1265815997 · NPPES record last updated Jul 12, 2022
Key facts
- NPI
- 1265815997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prosthodontics 1223P0700X
- License
- DNF000405 (GA)
- Practice address
- 1430 John Wesley Gilbert Drive
Augusta, GA 30912-0415 - Phone
- (706) 721-2696
- Fax
- (706) 721-6778
- NPI assigned
- Jun 30, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DNF000405 | GA | MD | Prosthodontist |
| 35962 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 35962 | TX | |
| Prosthodontics | 1223P0700X | DNF000405 | GA | Yes |
Addresses
Primary practice location
1430 John Wesley Gilbert Drive
Augusta, GA 30912-0415
Mailing address
1130 Hunters CV
Evans, GA 30809-6903
Phone (786) 304-3793
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.