NPIMap

Organization Active NPI

Mohd Awwad ,DDS , Inc

  • General Practice Dentistry
  • Eureka, CA
National Provider Identifier
1689885261
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
45428 Issued in CA
Legal business name
MOHD AWWAD ,DDS , INC
Practice address
3144 Broadway St
Suite C1
Eureka, CA 95501-3838
Phone
(707) 443-9374
Fax
(707) 443-9376
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mohd Awwad, DDSNPI 1508857673
Title
President
Phone
(707) 443-9374

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 45428 CA Primary

Addresses

Primary practice location

3144 Broadway St
Suite C1
Eureka, CA 95501-3838

Mailing address

3144 Broadway St
Suite C1
Eureka, CA 95501-3838
Phone (707) 443-9374

Other names 1

  • victoria place dental center Doing business as

National Provider Directory

National Provider Directory

Locations

3144 Broadway
Ste C1
Eureka, CA 95501
Phone (707) 443-9374

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689885261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3144 BROADWAY ST",
            "address_2": "SUITE C1",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013838",
            "telephone_number": "707-443-9374",
            "fax_number": "707-443-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3144 BROADWAY ST",
            "address_2": "SUITE C1",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013838",
            "telephone_number": "707-443-9374",
            "fax_number": "707-443-9376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHD AWWAD ,DDS , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AWWAD",
        "authorized_official_first_name": "MOHD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-443-9374",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "victoria place dental center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.