S Gewaid DDS, Professional Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

49753 Issued in CA

Legal business name

S GEWAID DDS, PROFESSIONAL DENTAL CORPORATION

Practice address

470 N. 3Rd Ave.
Upland, CA 91786-4703

Phone

(909) 982-9800

Fax

(909) 982-8500

NPI assigned

May 3, 2007

Last updated

Aug 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shenouda Fathy Gewaid, DDS

Title

Owner

Phone

(909) 982-9800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1356563084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 N. 3RD AVE.",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-982-9800",
            "fax_number": "909-982-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 N. 3RD AVE.",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864703",
            "telephone_number": "909-982-9800",
            "fax_number": "909-982-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S GEWAID DDS, PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "GEWAID",
        "authorized_official_first_name": "SHENOUDA",
        "authorized_official_middle_name": "FATHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-982-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Upland, CA
• Providers in Upland, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.