Provider Demographics
NPI:1538641436
Name:NEUROMUSCULAR DENTAL PROFESSIONALS
Entity Type:Organization
Organization Name:NEUROMUSCULAR DENTAL PROFESSIONALS
Other - Org Name:MICHIGAN CLINIC FOR DENTAL SLEEP MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YASER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHEEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:248-541-2588
Mailing Address - Street 1:6148 MEADOWVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4750
Mailing Address - Country:US
Mailing Address - Phone:313-918-5188
Mailing Address - Fax:
Practice Address - Street 1:3211 COOLIDGE HWY
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1633
Practice Address - Country:US
Practice Address - Phone:248-541-2588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment