Provider Demographics
NPI:1023393394
Name:FARAJ, ABIR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ABIR
Middle Name:
Last Name:FARAJ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23975 NOVI RD
Mailing Address - Street 2:STE A102
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2459
Mailing Address - Country:US
Mailing Address - Phone:248-348-5151
Mailing Address - Fax:248-348-5195
Practice Address - Street 1:23975 NOVI RD
Practice Address - Street 2:STE A102
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2459
Practice Address - Country:US
Practice Address - Phone:248-348-5151
Practice Address - Fax:248-348-5195
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010190021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice