Provider Demographics
NPI:1427850445
Name:MUSTAFA ALWAN DDS LLC
Entity type:Organization
Organization Name:MUSTAFA ALWAN DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-768-1573
Mailing Address - Street 1:515 JOHNSTOWN DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-8114
Mailing Address - Country:US
Mailing Address - Phone:615-768-1573
Mailing Address - Fax:
Practice Address - Street 1:311 E MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2582
Practice Address - Country:US
Practice Address - Phone:615-768-1573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental