Mohammed Ali Kanawati, DDS,MBA,MS

Primary specialty

DentistTaxonomy code 122300000X

License

30-022374 Issued in OH

Practice address

31099 Chagrin Blvd
Suite 100
Pepper Pike, OH 44124-5958

Phone

(216) 450-5888

Fax

(216) 450-5505

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. M. Ali Kanawati Other name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Master of Science

State licenses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1992912869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3671 COLUMBIA RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440702038",
            "telephone_number": "216-450-5888",
            "fax_number": "216-450-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31099 CHAGRIN BLVD",
            "address_2": "SUITE 100",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245958",
            "telephone_number": "216-450-5888",
            "fax_number": "216-450-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAWATI",
        "first_name": "MOHAMMED",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "DDS,MBA,MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-022374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE DENTAL LICENSE",
            "identifier": "30-022374",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M.",
            "last_name": "KANAWATI",
            "middle_name": "ALI",
            "prefix": "DR.",
            "credential": "DDS, MBA, MS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Whitney C Jones, LSW
• Jasmine G Jordan, LSW
• Vanessa Jordan, LSW
• Deborah L Joyce, RN
• Satish C Kalhan, MD
• Matthew S Karnak, LISW
• Barbara H Kaufman, M.D.
• Cindy R Kaufman, LISW-SUPV
• Lana Marie Khaddam, CT
• Taj Amjad Khan, M.D.

• Dentist in Pepper Pike, OH
• Providers in Pepper Pike, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.