Provider Demographics
NPI:1255457131
Name:KARAM, LINA N (DMD)
Entity type:Individual
Prefix:DR
First Name:LINA
Middle Name:N
Last Name:KARAM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-1078
Mailing Address - Country:US
Mailing Address - Phone:734-764-1542
Mailing Address - Fax:734-615-1415
Practice Address - Street 1:7200 DAN HOEY RD STE A
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-4201
Practice Address - Country:US
Practice Address - Phone:734-726-0760
Practice Address - Fax:877-514-3452
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901017982122300000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1958111880OtherBCBS OF MI MED SURGICAL
MID179820OtherBCBS OF MI DENTAL
MI4723610Medicaid
MI4723600Medicaid
MI4723610Medicaid
MI4723600Medicaid