Husam (Sam) Muwafaq, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10476 Issued in KY

Practice address

150 Mount Vernon Dr Ste 201
Georgetown, KY 40324-1410

Phone

(859) 317-3864

NPI assigned

Apr 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: hmuwafaq25325@ukhcdirect.org

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.

• Georgetown Sedation Dentistry

  • Dental Clinic/Center
  • Georgetown, KY
  • NPI 1992582571
  NPD

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1376172379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MOUNT VERNON DR STE 201",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241410",
            "telephone_number": "859-317-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MOUNT VERNON DR STE 201",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241410",
            "telephone_number": "859-317-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUWAFAQ",
        "first_name": "HUSAM (SAM)",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muha Optometric Group, PLLC
• Swati S Mulay
• Julie Mulholland, M.S. CCC-SLP
• Michelle Faith Muncy, LMFT, CBIS, TCADC
• Vinod Kumar Muniswamy, M.D., M.P.H
• Kelli Myers, PHARMD
• Mandy R Mynhier, PA-C
• Narayan Venguswamy PSC
• Narayan Venguswamy PSC
• New Approach Speech Therapy/Literacy Is Key Speech Therapy (Literacy is Key Speech Therapy)

• General Practice Dentistry in Georgetown, KY
• Providers in Georgetown, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.