Active NPI
Mahmoud Elfar
- Dentist
- Chesapeake, VA
National Provider Identifier
1619612678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401418096
- Practice address
- 1230 Progressive Dr Ste 103
Chesapeake, VA 23320-0203 - Phone
- (757) 436-1270
- Fax
- (757) 436-2973
- NPI assigned
- May 3, 2022
- Last updated
- Dec 10, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401418096 | VA | Primary |
Addresses
Primary practice location
1230 Progressive Dr Ste 103
Chesapeake, VA 23320-0203
Mailing address
1230 Progressive Dr Ste 103
Chesapeake, VA 23320-0203
Phone (757) 436-1270
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0401418096 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Professionals of Virginia, P.C | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba LWSS Family Dentistry - Chesapeake
- General Practice Dentistry
- Chesapeake, VA
- NPI 1700543741
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670630400000",
"number": "1619612678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1230 PROGRESSIVE DR STE 103",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233200203",
"telephone_number": "757-436-1270",
"fax_number": "757-436-2973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 PROGRESSIVE DR STE 103",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233200203",
"telephone_number": "757-436-1270",
"fax_number": "757-436-2973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELFAR",
"first_name": "MAHMOUD",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-05-03",
"last_updated": "2022-12-10",
"certification_date": "2022-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401418096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.