Jamal Bajwa
Individual provider Active NPI Dentist · Hahira, GA
NPI 1952889263 · NPPES record last updated May 18, 2026
Key facts
- NPI
- 1952889263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN015731 (GA)
- Practice address
- 950 Ga Highway 122 W
Hahira, GA 31632-1061 - Phone
- (919) 410-0014
- NPI assigned
- Jul 30, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12167 | NC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN015731 | GA | Yes |
| General Practice Dentistry | 1223G0001X | 12167 | NC |
Addresses
Primary practice location
950 Ga Highway 122 W
Hahira, GA 31632-1061
Mailing address
3711 Olympia Dr
Raleigh, NC 27603-3460
Phone (336) 588-6096
Other providers in Hahira, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.