Fady Mourad Wadie, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02505900 Issued in NJ

Practice address

2640 Route 70
Unit 2-D
Manasquan, NJ 08736-2609

Phone

(732) 223-2334

NPI assigned

Jun 25, 2012

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Smile by Kyle

  • Dentist
  • Manasquan, NJ
  • NPI 1689536864
  NPD (past)

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1386908317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 ROUTE 70",
            "address_2": "UNIT 2-D",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087362609",
            "telephone_number": "732-223-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 ROUTE 70",
            "address_2": "UNIT 2-D",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087362609",
            "telephone_number": "732-223-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADIE",
        "first_name": "FADY",
        "middle_name": "MOURAD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02505900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank C Victor, MD
• Frank R Victor, DC
• Kathryn Vieira, FNP-C
• John Christian Volpe, D.C.
• Kurt Eugene Von Suskil, MD
• Daniel Allan Walenjus, DDS
• Wall Eye Care Associates P a
• Jennifer Lynn Ward, O.D.
• Pamela Wasman Jones
• Brittany Anastasia Weber, LCSW

• General Practice Dentistry in Manasquan, NJ
• Providers in Manasquan, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.