Mohammad Walid Omary, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010560 Issued in AZ

Practice address

155 W Riverside Dr
Parker, AZ 85344-5221

Phone

(928) 669-0099

NPI assigned

Aug 18, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mohammad Walid Omary Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Parker Dental Center LLC

  • Dental Clinic/Center
  • Parker, AZ
  • NPI 1093464711
  NPD
• Parker Dental

  • Clinic/Center
  • Lake Havasu City, AZ
  • NPI 1962056572
  NPD (past)

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1306458740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17443 ELKWOOD ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254432",
            "telephone_number": "818-674-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W RIVERSIDE DR",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853445221",
            "telephone_number": "928-669-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMARY",
        "first_name": "MOHAMMAD",
        "middle_name": "WALID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOHAMMAD",
            "last_name": "OMARY",
            "middle_name": "WALID",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jesdeen Lynn Nunez
• Beverly O'Brallaghan, RN
• Sherry O'Leary, RN
• Stephanie A O'Neal, PT
• Nichelle Oakland
• Cody Ray Paddock
• Staci Ann Page, PA-C
• Roland Allen Palmquist, DPM
• Parker Community Senior Center
• Parker Dental Center LLC

• General Practice Dentistry in Parker, AZ
• Providers in Parker, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.