Healthcare Provider Details

I. General information

NPI: 1558174441
Provider Name (Legal Business Name): WALID AAWAR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E DR MARTIN L KING JR BLVD
ROSEBORO NC
28382-9063
US

IV. Provider business mailing address

106 BOLDLEAF CT
CARY NC
27513-3812
US

V. Phone/Fax

Practice location:
  • Phone: 910-525-5115
  • Fax: 910-525-3513
Mailing address:
  • Phone: 919-221-0945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14085
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: