Active NPI
Mouhammad Hazem Seirawan, DDS MPH MS
- Pediatric Dentistry
- Charlottesville, VA
National Provider Identifier
1407183080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 58671
- Practice address
- 1470 Pantops Mountain PL
Children'S Dentistry of Charlottesville
Charlottesville, VA 22911-4600 - Phone
- (434) 817-1817
- NPI assigned
- Nov 3, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 58671 | CA | Primary |
Addresses
Primary practice location
1470 Pantops Mountain PL
Children'S Dentistry of Charlottesville
Charlottesville, VA 22911-4600
Mailing address
1430 Tanglewood Dr.
Corona, CA 92882
Phone (909) 613-1144
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58671 | CA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505088000000",
"number": "1407183080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1430 TANGLEWOOD DR.",
"city": "CORONA",
"state": "CA",
"postal_code": "92882",
"telephone_number": "909-613-1144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1470 PANTOPS MOUNTAIN PL",
"address_2": "CHILDREN'S DENTISTRY OF CHARLOTTESVILLE",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229114600",
"telephone_number": "434-817-1817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEIRAWAN",
"first_name": "MOUHAMMAD",
"middle_name": "HAZEM",
"name_prefix": "Dr.",
"credential": "DDS MPH MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-11-03",
"last_updated": "2017-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "58671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.