Individual provider Active NPI

Ahmed Jawad Kadhim

  • General Practice Dentistry
  • Cypress, TX
National Provider Identifier
1629831466
Registry record updated Sep 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41307 Issued in TX
Practice address
13711 Flint Hollow Dr
Cypress, TX 77433-8879
Phone
(724) 302-6048
NPI assigned
Feb 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN10000467 MA
General Practice Dentistry 1223G0001X 41307 TX Primary

Addresses

Primary practice location

13711 Flint Hollow Dr
Cypress, TX 77433-8879

Mailing address

13711 Flint Hollow Dr
Cypress, TX 77433-8879
Phone (724) 302-6048

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
DN10000467MAMDGeneral Practice Dentistry
41307TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789171200000",
    "number": "1629831466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13711 FLINT HOLLOW DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774338879",
            "telephone_number": "724-302-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13711 FLINT HOLLOW DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774338879",
            "telephone_number": "724-302-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADHIM",
        "first_name": "AHMED",
        "middle_name": "JAWAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-05",
        "last_updated": "2026-09-12",
        "certification_date": "2026-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN10000467",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "41307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2026; 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.