DR. FAHAD SIDDIQUI (NPI# 1104307651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104307651 |
| Entity Type | Individual |
| Full Name | DR. FAHAD SIDDIQUI |
| Practice Address |
2700 Martin Luther King Jr Blvd Detroit MI 48208-2576 |
| Mailing Address |
5580 Nottingham Ct Apt 210 Dearborn MI 48126-2672 |
| Practice Telephone | 3134946700 |
| Mailing Telephone | 7327995756 |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2019-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2901600262 | MI | Dental Providers |
| Street Address |
2700 MARTIN LUTHER KING JR BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48208-2576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144215005 | Salvatore Russell Cutino | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2005-09-16 |
| 1730780933 | Mariam Khan | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-11-04 |
| 1508466350 | Shriya Kulkarni | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-10-30 |
| 1487267373 | Ranjitha Rai Padhiar | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-08-28 |
| 1518575810 | Robert Samuel Herman | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-07-22 |
| 1598383267 | Tingxi Liu | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-07-09 |
| 1457976680 | Alexandria Horner | Student in an Organized Health Care Education/Training Program | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-06-13 |
| 1184248692 | Asita Jenani Vinayagalingam | Student in an Organized Health Care Education/Training Program | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-05-31 |
| 1659993384 | Monica Gandhi | Student in an Organized Health Care Education/Training Program | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-05-15 |
| 1962023705 | Alexa Simmons | Student in an Organized Health Care Education/Training Program | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-05-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1932645405 | Diane Louise Dodson | Counselor | 5500 Trumbull Apt 315, Detroit, MI 48208 | 2017-01-09 |
| 1164881306 | Cory Eugene Martin | Counselor | 1852 W. Grand Blvd., Detroit, MI 48208 | 2016-02-16 |
| 1578947784 | Hamza Belhaj | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2015-07-17 |
| 1942629167 | Diana Pool | Counselor | 3737 Lawton, Detroit, MI 48208 | 2014-04-15 |
| 1124467048 | Aisha Williams | Social Worker | 4707 Vinewood St., Detroit, MI 48208 | 2013-06-25 |
| 1295079895 | Mia Love | Nurse Practitioner | 2959 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2012-11-20 |
| 1992064356 | Valarie Egeria Foulks | Counselor | 2051 W. Grand Blvd, Detroit, MI 48208 | 2012-05-04 |
| 1023304078 | Ayana Njeri Davis | Massage Therapist | 2550 W. Grand Blvd, Detroit, MI 48208 | 2011-06-28 |
| 1184922627 | Shar Inc. | Community Based Residential Treatment Facility, Mental Illness | 1852 W.grand Blvd, Detroit, MI 48208 | 2011-03-08 |
| Find all providers in zip 48208 | ||||
| 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 |
|---|---|---|---|---|
| 1669722856 | Richard Iain Tann | Dentist | 79 W Alexandrine St Fl 3, Detroit, MI 48201-2015 | 2012-09-14 |
| 1093846974 | Mona Rizk Ibrahim | Dentist | Detroit Health Dept. - Herman Kiefer Health Complex, 1151 Taylor Street, 7th Floor Pediatric Dental Clinic, Detroit, MI 48202-1732 | 2007-03-09 |
| 1801846985 | James Patrick Stenger | Dentist | 79 W Alexandrine St, 3rd Floor, Detroit, MI 48201-2015 | 2006-05-11 |
| 1104482439 | Childrens Dental Care of Detroit | Dentist | 430 Mack Ave, Detroit, MI 48201-2136 | 2019-05-13 |
| 1992165930 | Rehab Alabduljabbar | Dentist | 2700 Mlk Jr Blvd, Detroit, MI 48208-2576 | 2016-03-03 |
| 1851751150 | Thomas Veraldi, Dmd Residency and Hospital Practice, PC | Dentist | 79 W Alexandrine St, 3rd Flr, Detroit, MI 48201-2015 | 2016-02-29 |
| 1215215298 | Deliver Dental Solutions, Inc. | Dentist | 79 W Alexandrine St, 3rd Floor, Detroit, MI 48201-2015 | 2011-07-25 |
| 1821304858 | Kristen Charlene Ponichter | Dentist | 7633 E Jefferson Ave, Detroit, MI 48214-3730 | 2010-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033717558 | Discover Smiles Pediatric Dentistry | Dentist | 2277 Science Pkwy Ste 2, Okemos, MI 48864-2551 | 2020-10-16 |
| 1740898873 | Megan E Stowers Dds Ms Plc | Dentist | 7459 Middlebelt Rd Ste 1, West Bloomfield, MI 48322-4184 | 2020-07-15 |
| 1447884069 | Jocelyn M. Robelli Dds, Ms, Pllc | Dentist | 18245 E 10 Mile Rd Ste 110, Roseville, MI 48066-5807 | 2020-02-24 |
| 1457914038 | Mitten Kids Dentistry Caledonia Plc | Dentist | 6477 Cherry Meadow Dr Se Ste 4, Caledonia, MI 49316-7351 | 2019-04-18 |
| 1780143982 | Childrens Dental Specialists of Hazel Park Pllc | Dentist | 22241 John R Rd, Hazel Park, MI 48030-1716 | 2019-03-18 |
| 1487128120 | Dental Group Associates PC | Dentist | 4505 Cascade Rd Se # B, Grand Rapids, MI 49546-8381 | 2019-01-16 |
| 1184194433 | Pediatric Dental Specialists of West Michigan | Dentist | 2155 E Paris Ave Se Ste 120, Grand Rapids, MI 49546-6142 | 2018-11-29 |
| 1811465990 | Kingma Pediatric Dentistry Pllc | Dentist | 1179 E Paris Ave Se Ste 130, Grand Rapids, MI 49546-3682 | 2018-11-07 |
| 1407322548 | Great Lakes Bay Pediatric Dentistry, Plc | Dentist | 5605 Colony Dr N Ste 2, Saginaw, MI 48638-7187 | 2018-10-16 |
| 1063987725 | Little Red Pediatric Dentistry, Plc | Dentist | 12723 N Bellwood Dr Ste 20, Holland, MI 49424-7275 | 2018-10-09 |
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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.