Atef Milad Tawadros, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12008042A Issued in IN

Practice address

116 W 3Rd St
Mishawaka, IN 46544-2024

Phone

(574) 255-2636

NPI assigned

May 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1326041328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 W 3RD ST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465442024",
            "telephone_number": "574-255-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W 3RD ST",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465442024",
            "telephone_number": "574-255-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWADROS",
        "first_name": "ATEF",
        "middle_name": "MILAD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12008042A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Habiba Tariq, M.D
• Julia Marie Tarpley, PAC
• Guy Tatay, MS
• Aajahne Tate
• Alexander Marcus Tawadros, MD
• Kelsea M Taylor Miner, LMHC NCC MSED
• Aerial Leanna Taylor
• Elaie Taylor
• Elizabeth Taylor
• Linda Rae Taylor, LCSW

• Oral and Maxillofacial Surgery (Dentist) in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.