Provider Demographics
NPI:1093385866
Name:ROUMAYAH, DAHA (DDS)
Entity Type:Individual
Prefix:
First Name:DAHA
Middle Name:
Last Name:ROUMAYAH
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 1:5342 WINDHAM HILL CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2782
Mailing Address - Country:US
Mailing Address - Phone:248-738-8973
Mailing Address - Fax:
Practice Address - Street 1:37595 7 MILE RD # 450
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1003
Practice Address - Country:US
Practice Address - Phone:734-855-4474
Practice Address - Fax:734-855-4470
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600962122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2901600962OtherDENTAL LICENSE