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General NPI Number Information
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NPI Number | 1962759324
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Entity Type | Individual
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Provider Name | MUHANAD AWNI SALEM DMD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2012
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 4867 BAXTER RD STE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-4469
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Country | US
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Telephone | 757-499-8139
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Fax |
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Provider Business Mailing Address
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Address Line | 4867 BAXTER RD STE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-4469
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Country | US
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Telephone | 757-499-8139
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Fax | 757-473-8816
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1856055
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401414313
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License Number State | VA
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