Provider Demographics
NPI:1598980120
Name:EL-SHAREIF, MOHAMMED (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:
Last Name:EL-SHAREIF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3089 CREEK DR SE
Mailing Address - Street 2:APT. 3-A
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512-8159
Mailing Address - Country:US
Mailing Address - Phone:616-245-2767
Mailing Address - Fax:616-245-0498
Practice Address - Street 1:2020 DIVISION AVE S
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-3029
Practice Address - Country:US
Practice Address - Phone:616-245-2767
Practice Address - Fax:616-245-0498
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010182961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice