Individual provider Active NPI

Mohammed Nadimul Islam, D.D.S, B.D.S

  • Oral and Maxillofacial Pathology Dentistry
  • Gainesville, FL
National Provider Identifier
1477750263
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
12011554A Issued in IN
Practice address
1395 Center Dr
RM D8-6C
Gainesville, FL 32610-0405
Phone
(352) 294-5711
Fax
(352) 294-5310
NPI assigned
Jun 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 12011554A IN Primary

Addresses

Primary practice location

1395 Center Dr
RM D8-6C
Gainesville, FL 32610-0405

Mailing address

9750 SW Nimbus Ave
Beaverton, OR 97008-7172
Phone (503) 906-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20120925000089 FL Practitioner - Oral and Maxillofacial PathologyPractitioner - Oral Surgery 7113108010 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral and Maxillofacial Pathology
Education
Indiana University School of Dentistry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faculty Associates IncorporatedGroup PAC ID 4981707460, 16 clinicians

Practice addresses (Care Compare)

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 273-5380

1600 SW Archer Rd
PO Box 100425
Gainesville, FL 32610-0425

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Oct 6, 2012 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Oct 6, 2012 Accepting new patients
Faculty Associates Incorporated CurrentSince Sep 15, 2012 Accepting new patients
Faculty Associates, Inc Past Accepting new patients
Curtis T. Thompson, M.D. & Associates, PLLC Oral and Maxillofacial Pathology PastSince May 14, 2023 Accepting new patients
Cta Oral Pathology Consultants of Michigan, PLLC Oral and Maxillofacial Pathology Past Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1600 SW Archer Rd
Rm D26
Gainesville, FL 32610
Phone (352) 273-5380

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mislam84917@direct.shands.ufl.edu

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1477750263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9750 SW NIMBUS AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087172",
            "telephone_number": "503-906-7300",
            "fax_number": "503-245-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CENTER DR",
            "address_2": "RM D8-6C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100405",
            "telephone_number": "352-294-5711",
            "fax_number": "352-294-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MOHAMMED",
        "middle_name": "NADIMUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S, B.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "IN",
            "license": "12011554A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.