Provider Demographics
NPI:1851788939
Name:A PLUS DENTISTRY DDS PC
Entity Type:Organization
Organization Name:A PLUS DENTISTRY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BASEM
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-TAANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-495-9460
Mailing Address - Street 1:47166 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2583
Mailing Address - Country:US
Mailing Address - Phone:734-495-9460
Mailing Address - Fax:734-495-9461
Practice Address - Street 1:47166 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-2583
Practice Address - Country:US
Practice Address - Phone:734-495-9460
Practice Address - Fax:734-495-9461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010181421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2901018142Medicaid