Provider Demographics
NPI:1093493702
Name:SHAWI, MOHAMED B (DMD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:B
Last Name:SHAWI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927-4991
Mailing Address - Country:US
Mailing Address - Phone:609-418-9135
Mailing Address - Fax:
Practice Address - Street 1:780 WEST AVE
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32927-4991
Practice Address - Country:US
Practice Address - Phone:321-631-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02981901122300000X
NJ22DI02981900122300000X
FLDN28841122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist