Provider Demographics
NPI:1821657172
Name:AMEEN, MOHAMMED (DDS)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:
Last Name:AMEEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 BLOOMFIELD LN APT 1111
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-3636
Mailing Address - Country:US
Mailing Address - Phone:248-881-5761
Mailing Address - Fax:
Practice Address - Street 1:3375 S AIRPORT RD W
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7929
Practice Address - Country:US
Practice Address - Phone:231-903-0661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901023219122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist