Sami Kawas, DDS

Individual provider Active NPI General Practice Dentistry · Waunakee, WI

NPI 1609301027 · NPPES record last updated Sep 8, 2022

Key facts

NPI
1609301027
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
1001967 (WI)
Practice address
1141 Simon Crestway
Waunakee, WI 53597-1879
Phone
(608) 849-5600
NPI assigned
Apr 24, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190807003830 WI Order and Referring Only - Dentist
Practitioner - Dentist
6800123209

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1001967WIMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1001967 WI Yes

Addresses

Primary practice location

1141 Simon Crestway
Waunakee, WI 53597-1879

Mailing address

1141 Simon Crestway
Waunakee, WI 53597-1879
Phone (608) 849-5600

Other providers in Waunakee, WI

All providers in Waunakee, WI · General Practice Dentistry in Wisconsin

Sources for this page

Verify at the official NPI Registry.