Provider Demographics
NPI:1659708360
Name:REDA ISMAIL & ASSOCIATES DDS PLLC
Entity Type:Organization
Organization Name:REDA ISMAIL & ASSOCIATES DDS PLLC
Other - Org Name:DENTAL CARE ADULTS & CHILDREN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:REDA
Authorized Official - Middle Name:EL-ZEIN
Authorized Official - Last Name:ISMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-381-3850
Mailing Address - Street 1:24326 W WARREN ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2234
Mailing Address - Country:US
Mailing Address - Phone:313-381-3850
Mailing Address - Fax:313-389-0046
Practice Address - Street 1:24326 W WARREN ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2234
Practice Address - Country:US
Practice Address - Phone:313-381-3850
Practice Address - Fax:313-389-0046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019780122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty