Provider Demographics
NPI:1134650450
Name:EIWAZ, SARMAD RAMZI (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARMAD
Middle Name:RAMZI
Last Name:EIWAZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32905 W 12 MILE RD
Mailing Address - Street 2:SUITE 140 BUILDING D
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1982
Mailing Address - Country:US
Mailing Address - Phone:248-516-0004
Mailing Address - Fax:248-522-4626
Practice Address - Street 1:32905 W 12 MILE RD
Practice Address - Street 2:SUITE 140 BUILDING D
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1982
Practice Address - Country:US
Practice Address - Phone:248-516-0004
Practice Address - Fax:248-522-4626
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010223311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice