Provider Demographics
NPI:1679906499
Name:SHIVA HOGUGI PLLC
Entity Type:Organization
Organization Name:SHIVA HOGUGI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGUGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-669-5110
Mailing Address - Street 1:2300 HAGGERTY RD STE 1170
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2187
Mailing Address - Country:US
Mailing Address - Phone:248-669-5110
Mailing Address - Fax:
Practice Address - Street 1:2300 HAGGERTY RD STE 1170
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-2187
Practice Address - Country:US
Practice Address - Phone:248-669-5110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010174951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty