Fawzi Hijazi, BDS,DDS,CDT

Primary specialty

DentistTaxonomy code 122300000X

License

30682 Issued in TX

Practice address

235 E Hildebrand Ave # 200
San Antonio, TX 78212-2430

Phone

(210) 821-5316

Fax

(210) 829-4686

NPI assigned

Nov 24, 2014

Last updated

Apr 14, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drhijazi@greatlifedental.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reconstructive Dental Specialists of Texas

  dba Great Life Dental

  • Prosthodontics
  • San Antonio, TX
  • NPI 1083263149
  NPD Authorized official

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1427455195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E HILDEBRAND AVE # 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782122430",
            "telephone_number": "210-821-5316",
            "fax_number": "210-829-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E HILDEBRAND AVE # 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782122430",
            "telephone_number": "210-821-5316",
            "fax_number": "210-829-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIJAZI",
        "first_name": "FAWZI",
        "name_prefix": "Dr.",
        "credential": "BDS,DDS,CDT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-24",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00202435",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drhijazi@greatlifedental.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "235 E Hildebrand Ave # 200",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782122430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Hightower, CCP
• Haley Higley, CNIM
• Junji Henry Higuchi, MD
• Adeline E Hij, APRN FNP-C
• Ashley Hijazi
• Mayra Isabel Hilario
• Douglas Raymond Hilbert, MD
• Laura Hilbert, LCPC
• Carl Hilbig, CST/CSFA
• Rhonda Hilburn

• Dentist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.