Provider Demographics
NPI:1205018371
Name:KATRANJI, GHALIA KAYALI
Entity Type:Individual
Prefix:DR
First Name:GHALIA
Middle Name:KAYALI
Last Name:KATRANJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1756 N TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1271
Mailing Address - Country:US
Mailing Address - Phone:313-563-6601
Mailing Address - Fax:313-563-6986
Practice Address - Street 1:1565 W BIG BEAVER RD BLDG F
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3525
Practice Address - Country:US
Practice Address - Phone:248-649-1975
Practice Address - Fax:248-649-1975
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901015470122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist