DR. KHALID HASSAN MUTAWALLI (NPI# 1750754818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750754818 |
| Entity Type | Individual |
| Full Name | DR. KHALID HASSAN MUTAWALLI |
| Credential | D.D.S,M.S |
| Practice Address |
3625 College Ave Bx1822 Davie FL 33314-7724 |
| Mailing Address |
215 Se 8th Ave Apt#1640 Fort Lauderdale FL 33301-3644 |
| Practice Telephone | 2025603320 |
| Mailing Telephone | 2025603320 |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2016-09-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN 20908 | FL | Dental Providers |
| Street Address |
3625 COLLEGE AVE BX1822 |
| City | DAVIE |
| State | FL |
| Zip Code | 33314-7724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386119949 | Tiffany Allen | Case Manager/Care Coordinator | 6602 Sw 41st Street, Davie, FL 33314 | 2018-10-10 |
| 1053804047 | Shannon Stowe | Specialist/Technologist | 3160 Palm Trace Landings Dr Apt 731, Davie, FL 33314 | 2018-06-13 |
| 1700374238 | Christian D Cameron | Developmental Therapist | 5900 Sw 24th Pl Unit 203, Davie, FL 33314 | 2018-04-30 |
| 1902308836 | Infusion Nurse Experts LLC | Home Health | 4802 Sw 51st Street, Davie, FL 33314 | 2018-03-07 |
| 1134658495 | Luz Arevalo | Behavioral Analyst | 6630 Sw 41 Pl, Davie, FL 33314 | 2017-06-08 |
| 1194253815 | Migdalis Padron | Behavior Technician | 4491 Sw 52nd Ct Apt 8, Fort Lauderdale, FL 33314 | 2017-05-25 |
| 1710240833 | Victor Pabon | Adult Companion | 4828 Sw 47 Lane, Davie, FL 33314 | 2012-06-22 |
| 1437433802 | Laura Maritsa Canciani | Counselor | 6005 Stirling Road #124, Davie, FL 33314 | 2011-10-04 |
| 1770729840 | Therapeeds, Inc. | Occupational Therapist | 5951 Orange Drive, Davie, FL 33314 | 2008-12-19 |
| 1861690851 | Craig Alan Handwerker | Counselor | 4200 Sw 54th Ct, Fort Lauderdale, FL 33314 | 2007-07-11 |
| Find all providers in zip 33314 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205180171 | Richard L. Sherman, D.d.s. | Dentist | 4725 Sw 148 Ave. Suite 203, Davie, FL 33330 | 2012-10-31 |
| 1740354174 | Maria Grazia Marranzini | Dentist | 4401 S Flamingo Rd, Ste 109, Davie, FL 33330-1914 | 2006-11-18 |
| 1396356275 | Fahra Y Dawood | Dentist | 3200 S University Dr, Davie, FL 33328-2018 | 2020-08-13 |
| 1487265476 | Ashley Culver | Dentist | 3200 S University Dr, Davie, FL 33328-2018 | 2020-08-12 |
| 1710535349 | David Nicholas Luther | Dentist | 8701 Sw 30th St Apt 206, Davie, FL 33328-1828 | 2019-08-27 |
| 1043681836 | Grosman Pediatric Dentistry and Orthodontics | Dentist | 4401 S Flamingo Rd, Ste 109, Davie, FL 33330-1914 | 2015-10-19 |
| 1750636049 | Selin Avman | Dentist | 3200 S University Dr, Davie, FL 33328-2018 | 2012-07-23 |
| 1811288012 | Nova Southeastern University, Inc | Dentist | 7600 Sw 36th Street, Bldg. # 100 Room 1263, Davie, FL 33328-1902 | 2011-04-22 |
| 1972605038 | Jose Carlos Larumbe | Dentist | 3200 S University Dr, Davie, FL 33328-2018 | 2006-09-01 |
| 1649386657 | William Roy Trevarthen | Dentist | 3200 S University Dr, Davie, FL 33328-2018 | 2006-08-22 |
| Find all providers in DAVIE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.