Provider Demographics
NPI:1114066586
Name:SHAKFA, ABDUL (DDS)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:
Last Name:SHAKFA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:ABDUL
Other - Middle Name:
Other - Last Name:SHAKFA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:28701 PLYMOUTH RD STE B
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-2421
Mailing Address - Country:US
Mailing Address - Phone:734-427-9300
Mailing Address - Fax:734-427-1200
Practice Address - Street 1:229 S COCHRAN AVENUE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813
Practice Address - Country:US
Practice Address - Phone:517-543-3810
Practice Address - Fax:517-543-3899
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI193881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice