Active NPI
Fahad Kidwai
- Dentist
- Rockville, MD
National Provider Identifier
1366982373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2002097075
- Practice address
- 848 New Mark Esplanade
Rockville, MD 20850-2750 - Phone
- (201) 685-2295
- NPI assigned
- Feb 24, 2017
- Last updated
- Feb 24, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2002097075 | MD | Primary |
Addresses
Primary practice location
848 New Mark Esplanade
Rockville, MD 20850-2750
Mailing address
848 New Mark Esplanade
Rockville, MD 20850-2750
Phone (201) 685-2295
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53231968 | Other | MD | KAISER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2002097075 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487894400000",
"number": "1366982373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "848 NEW MARK ESPLANADE",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208502750",
"telephone_number": "201-685-2295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "848 NEW MARK ESPLANADE",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208502750",
"telephone_number": "201-685-2295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDWAI",
"first_name": "FAHAD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-24",
"last_updated": "2017-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "2002097075",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER",
"identifier": "53231968",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.