Omar Dwider, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS109717 Issued in CA

Practice address

467 College Blvd Ste 2
Oceanside, CA 92057-5436

Phone

(760) 631-3060

NPI assigned

Oct 11, 2020

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

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Rogers and Reagan Dental Corporation

  dba College Dental Group

  • General Practice Dentistry
  • Oceanside, CA
  • NPI 1275627051
  NPD (past)
• Mass Dental Associates

  • General Practice Dentistry
  • Boston, MA
  • NPI 1760653810
  NPD (past)

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

{
    "created_epoch": "1602374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1437757614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 COLLEGE BLVD STE 2",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920575436",
            "telephone_number": "760-631-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 COLLEGE BLVD STE 2",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920575436",
            "telephone_number": "760-631-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWIDER",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-11",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS109717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Lynn Duran, RBT
• Sayra Duran
• Erica Durant
• Jason Edwin Duryee, PMHNP
• Stephanie Duvernay
• Melona Ann Gallard Dy
• Clayton Carson Dyke III, PT
• Margaret Wegner Dyson, PH.D.
• Barry S Dzindzio, MD
• E & C Care Home II

• General Practice Dentistry in Oceanside, CA
• Providers in Oceanside, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.