Individual provider Active NPI

Nauman Ahmad Bajwa

  • Dentist
  • Riverside, CA
National Provider Identifier
1497364228
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
111437 Issued in CA
Practice address
3380 La Sierra Ave Ste 108
Riverside, CA 92503-5225
Phone
(469) 208-6771
NPI assigned
Jul 28, 2020
Reactivated
Sep 11, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36361 TX
Dentist 122300000X 111437 CA Primary

Addresses

Primary practice location

3380 La Sierra Ave Ste 108
Riverside, CA 92503-5225

Mailing address

3380 La Sierra Ave Ste 108
Riverside, CA 92503-5225
Phone (469) 208-6771

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

State licenses

LicenseStateTypeSpecialty
36361TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
MH Smiles LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

2101 Midway Rd
Ste 250
Carrollton, TX 75006
Phone (856) 484-6788

Organizations & group practices 1

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": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1497364228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 LA SIERRA AVE STE 108",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035225",
            "telephone_number": "469-208-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 LA SIERRA AVE STE 108",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035225",
            "telephone_number": "469-208-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJWA",
        "first_name": "NAUMAN",
        "middle_name": "AHMAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-28",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-11",
        "deactivation_date": "2024-08-22",
        "reactivation_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36361",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "111437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.