Medhat Dawoud, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02277600 Issued in NJ

Practice address

667 Eagle Rock Avenue
Second Floor, Ste B
West Orange, NJ 07052-2177

Phone

(973) 731-2000

Fax

(973) 731-2211

NPI assigned

Sep 14, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1578668372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 EAGLE ROCK AVENUE",
            "address_2": "SECOND FLOOR, STE B",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522177",
            "telephone_number": "973-731-2000",
            "fax_number": "973-731-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 EAGLE ROCK AVENUE",
            "address_2": "SECOND FLOOR, STE B",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522177",
            "telephone_number": "973-731-2000",
            "fax_number": "973-731-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWOUD",
        "first_name": "MEDHAT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02277600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel F Davis, DDS
• Marlene Phyllis Davis, MSW MED MA
• Michael Davis, LPC, BCPC
• Nastassia Davis, MSN, RN, IBCLC
• Christina B Davitt, APN
• Melissa De Gannes
• Adria De Simone, MS, CRC, LAC, CBIS
• Dia Deangelis
• Gerald Deangelis, LCSW
• Diane Rose Dearie, MA

• General Practice Dentistry in West Orange, NJ
• Providers in West Orange, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.