Provider Demographics
NPI:1659798239
Name:ALAMDI, ADNAN ISMAIL SR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADNAN
Middle Name:ISMAIL
Last Name:ALAMDI
Suffix:SR
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ADNAN
Other - Middle Name:ISMAIL
Other - Last Name:ALAMDI
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:350 N CLARK ST
Mailing Address - Street 2:6TH FLOOR CHICAGO
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-4712
Mailing Address - Country:US
Mailing Address - Phone:313-522-3015
Mailing Address - Fax:
Practice Address - Street 1:2501 W PIERSON RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-6802
Practice Address - Country:US
Practice Address - Phone:313-522-3015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021157122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist