Individual provider Active NPI

Mustafa Al Azzawi

  • Dentist
  • Nashua, NH
National Provider Identifier
1306629290
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN5378 Issued in ME
Practice address
225 Daniel Webster Hwy
Nashua, NH 03060-5536
Phone
(603) 769-8448
NPI assigned
Aug 15, 2023
Last updated
Jul 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 25736 FL
Dentist 122300000X 05206 NH
Periodontics 1223P0300X DL100711 MA
Dentist 122300000X DEN5378 ME Primary

Addresses

Primary practice location

225 Daniel Webster Hwy
Nashua, NH 03060-5536

Mailing address

70 Eastern Ave
Malden, MA 02148-5014
Phone (781) 338-0818

Other practice location 1

635 Albany St
Boston, MA 02118-3550
Phone (617) 458-8300

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

State licenses

LicenseStateTypeSpecialty
DEN5378MEMDDentist
05206NHMDDentist
DL100711MAMDPeriodontist
25736FLMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Dental PC CurrentSince Aug 1, 2023 Accepting new patients
Wollaston Dental Care, Inc PastSince Aug 1, 2023 Accepting new patients

Locations

70 Eastern Ave
Malden, MA 02148
Phone (781) 338-0818

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": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1306629290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 EASTERN AVE",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485014",
            "telephone_number": "781-338-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 DANIEL WEBSTER HWY",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030605536",
            "telephone_number": "603-769-8448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "635 Albany St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021183550",
            "country_code": "US",
            "telephone_number": "617-458-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL AZZAWI",
        "first_name": "MUSTAFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "FL",
            "license": "25736",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "05206",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DL100711",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "DEN5378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.