Provider Demographics
NPI:1225926363
Name:HUSSEIN, MOHAMED ALI (DMD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:ALI
Last Name:HUSSEIN
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 1:21710 BEECHCREST ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2405
Mailing Address - Country:US
Mailing Address - Phone:313-286-1888
Mailing Address - Fax:
Practice Address - Street 1:49175 PONTIAC TRL
Practice Address - Street 2:
Practice Address - City:WIXOM
Practice Address - State:MI
Practice Address - Zip Code:48393-2580
Practice Address - Country:US
Practice Address - Phone:248-859-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016026751223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health