Individual provider Active NPI

Fawad Javed, DDS, AEGD, PHD

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1750810198
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060349 Issued in NY
Practice address
625 Elmwood Avenue
Box 683
Rochester, NY 14620
Phone
(585) 275-8315
NPI assigned
Jun 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 060349 NY Primary

Addresses

Primary practice location

625 Elmwood Avenue
Box 683
Rochester, NY 14620

Mailing address

564 E Ridge Rd Ste 202
Rochester, NY 14621-1228
Phone (585) 266-0506

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
060349NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750810198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 E RIDGE RD STE 202",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146211228",
            "telephone_number": "585-266-0506",
            "fax_number": "585-270-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 ELMWOOD AVENUE",
            "address_2": "BOX 683",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14620",
            "telephone_number": "585-275-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVED",
        "first_name": "FAWAD",
        "name_prefix": "Dr.",
        "credential": "DDS, AEGD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.