Mohamad Fawaz, DMD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

DN123645 Issued in VA

Practice address

1430 John Wesley Gilbert Drive
Augusta, GA 30912-0566

Phone

(706) 288-6517

NPI assigned

May 25, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1629716907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 JOHN WESLEY GILBERT DRIVE AUGUSTA",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120257",
            "telephone_number": "706-288-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 JOHN WESLEY GILBERT DRIVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120566",
            "telephone_number": "706-288-6517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "VCUHS Dept of OMFS Residency",
            "address_2": "1250 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232980566",
            "country_code": "US",
            "telephone_number": "804-828-0602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAWAZ",
        "first_name": "MOHAMAD",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-25",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0442000458",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "DN123645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hasanali V Fatteh, MD
• Nadeem H Fatteh, M.D.
• John Daniel Faught
• Linda Ann Faulk, M.D.
• Jason Anthony Faunce, CRNA
• Oladapo O Fawibe I, MD
• Herbert Peter Fechter III, MD
• Kimberly Ann Fedele, CRNA
• Meghan Federman
• Kimberly Denise Fedrick, LPN

• Student in an Organized Health Care Education/Training Program in Augusta, GA
• Providers in Augusta, GA by specialty
• Student in an Organized Health Care Education/Training Program in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.