Individual provider Active NPI

Ahmad Hawwa

  • General Practice Dentistry
  • Chester, VA
National Provider Identifier
1275209389
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401418121 Issued in VA
Practice address
12712 Jefferson Davis Hwy # a
Chester, VA 23831-5369
Phone
(804) 214-7339
NPI assigned
Aug 18, 2021
Last updated
May 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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 0401418121 VA Primary

Addresses

Primary practice location

12712 Jefferson Davis Hwy # a
Chester, VA 23831-5369

Mailing address

11736 W Broad St Ste C112
Richmond, VA 23233-1189
Phone (804) 802-9999

Other practice location 1

530 E Main St Ste 400
Richmond, VA 23219-2431
Phone (804) 648-3507

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

Practice roles

OrganizationSpecialtyStatusNew patients
Richmond Family Dentistry at Short Pump General Practice CurrentSince May 26, 2024 Accepting new patients
Gold Dental Care, LLC General Practice Current Accepting new patients

Locations

11736 W Broad St
Ste C112
Richmond, VA 23233
Phone (310) 995-0492

530 E Main St
Ste 400
Richmond, VA 23219
Phone (804) 648-1305

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": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1275209389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11736 W BROAD ST STE C112",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232331189",
            "telephone_number": "804-802-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12712 JEFFERSON DAVIS HWY # A",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238315369",
            "telephone_number": "804-214-7339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 E Main St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232192431",
            "country_code": "US",
            "telephone_number": "804-648-3507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWWA",
        "first_name": "AHMAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-18",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.