PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN, LLC (NPI# 1912389842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912389842 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN, LLC |
| Other Organization Name | DENTAL CARE OF MICHIGAN, HAZEL PARK |
| Practice Address |
23528 John R Rd Hazel Park MI 48030-1409 |
| Practice Telephone | 2483971165 |
| Mailing Telephone | 2483971165 |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2015-06-27 |
| Authorized Official Name | DR. SHAKIB HALABU (DENTIST) |
| Authorized Official Telephone | 2483971165 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 2901011201 | MI | Dental Providers |
| Other Name | Type Code |
|---|---|
| Dental Care of Michigan, Hazel Park | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942740337 | Professional Dental Alliance of Michigan, LLC | Dentist | 23845 Van Dyke Ave, Center Line, MI 48015-1300 | 2017-03-03 |
| 1629440581 | Professional Dental Alliance of Michigan, LLC | Dentist | 25631 Gratiot Ave, Roseville, MI 48066-4434 | 2015-10-30 |
| 1851763387 | Professional Dental Alliance of Michigan, LLC | Dentist | 1658 Middlebelt Rd, Garden City, MI 48135-2879 | 2015-10-23 |
| 1124457494 | Professional Dental Alliance of Michigan, LLC | Dentist | 37595 7 Mile Rd, Ste 450, Livonia, MI 48152-1003 | 2013-11-06 |
| 1245589563 | Professional Dental Alliance of Michigan, LLC | Dentist | 31118 Harper Ave, Saint Clair Shores, MI 48082-1950 | 2012-08-31 |
| 1144579467 | Professional Dental Alliance of Michigan, LLC | Dentist | 69089 N Main St, Richmond, MI 48062-1146 | 2012-08-31 |
| Street Address |
23528 JOHN R RD |
| City | HAZEL PARK |
| State | MI |
| Zip Code | 48030-1409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801295910 | Julie Nunu | Dentist | 23528 John R Rd, Hazel Park, MI 48030-1409 | 2014-08-14 |
| 1093110496 | Rita Banno | Dentist | 23528 John R Rd, Hazel Park, MI 48030-1409 | 2014-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710254511 | Dennis Lee Levine | Family Medicine | 1142 E. 9 Mile Rd, Hazel Park, MI 48030 | 2011-11-22 |
| 1316167471 | Irwin Arnold Goodman | Dentist | 23941 John R., Hazel Park, MI 48030 | 2007-04-30 |
| 1053447490 | Thomas N Weigel Dds PC | Dentist | 23411 John R Street, Hazel Park, MI 48030 | 2007-02-27 |
| 1871668400 | Back In Line Chiropractic PC | Chiropractor | 712 E. 9 Mile Rd, Hazel Park, MI 48030 | 2006-11-21 |
| 1215025796 | Christopher Yon Chang | Physical Medicine & Rehabilitation | 704 E 9 Mile Rd, Hazel Park, MI 48030 | 2006-10-10 |
| 1043320302 | Ashtar Dentistry P.C. | Dentist | 23528 John R. Rd., Hazel Partk, MI 48030 | 2006-08-30 |
| 1477544088 | Musib S Gappy | Internal Medicine | 23411 John R, Hazel Park, MI 48030 | 2005-11-02 |
| 1639210693 | Basima Ykao Ykao-daman | Dentist | 23528 John R. Rd., Hazel Park, MI 48030 | 2007-02-10 |
| 1871674275 | Eye On Health P.C. | Optometrist | 22039 John R Rd, Hazal Park, MI 48030 | 2006-10-18 |
| 1356470520 | Randy Gordon Fillion | Massage Therapist | 98 W Garfield Ave, Hazel Park, MI 48030-1128 | 2007-03-05 |
| Find all providers in zip 48030 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003269960 | Caring Dentistry If Hazel Park, Pllc | Dentist | 1631 E 9 Mile Rd, Hazel Park, MI 48030-1938 | 2016-07-15 |
| 1801295910 | Julie Nunu | Dentist | 23528 John R Rd, Hazel Park, MI 48030-1409 | 2014-08-14 |
| 1316167471 | Irwin Arnold Goodman | Dentist | 23941 John R., Hazel Park, MI 48030 | 2007-04-30 |
| 1265040216 | Nehal Alkhawri | Dentist | 1631 E 9 Mile Rd, Hazel Park, MI 48030-1938 | 2020-07-16 |
| 1093110496 | Rita Banno | Dentist | 23528 John R Rd, Hazel Park, MI 48030-1409 | 2014-10-28 |
| 1639210693 | Basima Ykao Ykao-daman | Dentist | 23528 John R. Rd., Hazel Park, MI 48030 | 2007-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700986 | Lake Orion Family Dentistry | Dentist | 1320 S Lapeer Rd, Lake Orion, MI 48360-1435 | 2020-11-05 |
| 1093315202 | Peninsula Family Dentistry, PC | Dentist | 3210 Us 41 W, Marquette, MI 49855-9483 | 2020-10-27 |
| 1437758398 | Pristine Dental Care | Dentist | 3021 E Walton Blvd, Auburn Hills, MI 48326-2368 | 2020-10-21 |
| 1003414749 | Rami Ghandour | Dentist | G3023 Miller Rd, Flint, MI 48507-1353 | 2020-10-14 |
| 1013514538 | Ranim Suliman | Dentist | 9824 Conant St, Hamtramck, MI 48212 | 2020-10-07 |
| 1457968133 | Norman Family Dentistry PC | Dentist | 519 Ada Dr Se Ste A, Ada, MI 49301-9069 | 2020-09-28 |
| 1992312680 | Waely Dental Pllc | Dentist | 1769 Inkster Rd, Garden City, MI 48135-3028 | 2020-09-26 |
| 1164037362 | David Posada | Dentist | 1326 Marion Ave, Lincoln Park, MI 48146-2090 | 2020-09-14 |
| 1144835059 | Chelsea Anthony | Dentist | 23207 Norcrest Dr, Saint Clair Shores, MI 48080-2586 | 2020-09-09 |
| 1275147399 | Yuvraj Pannu | Dentist | 2501 W Pierson Rd Unit B, Flint, MI 48504-6802 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | HAZEL PARK |
| Zip Code | 48030 |
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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.