Provider Demographics
NPI:1376280537
Name:TAWEEL, KENAN E (DMD)
Entity Type:Individual
Prefix:DR
First Name:KENAN
Middle Name:E
Last Name:TAWEEL
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 1:6 STOKES RD APT 2B
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-5936
Mailing Address - Country:US
Mailing Address - Phone:708-663-5001
Mailing Address - Fax:
Practice Address - Street 1:6 STOKES RD APT 2B
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-5936
Practice Address - Country:US
Practice Address - Phone:708-663-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ22DI02902200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program