Individual provider Active NPI

Jalal Ahmad Almallouhi, DDS

  • Pediatric Dentistry
  • Waterford, MI
National Provider Identifier
1023869609
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2901602803 Issued in MI
Practice address
1265 W Huron St
Waterford, MI 48328-3677
Phone
(248) 977-3327
NPI assigned
Apr 1, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 2901602803 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1265 W Huron St
Waterford, MI 48328-3677

Mailing address

1265 W Huron St
Waterford, MI 48328-3677

Other practice location 1

2109 Hughes Dr
Toledo, OH 43606-3856
Phone (419) 291-7222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901602803MIMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1023869609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 W HURON ST",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283677",
            "fax_number": "248-977-3327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 W HURON ST",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283677",
            "telephone_number": "248-977-3327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2109 Hughes Dr",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436063856",
            "country_code": "US",
            "telephone_number": "419-291-7222",
            "fax_number": "419-291-8095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALMALLOUHI",
        "first_name": "JALAL",
        "middle_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-01",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901602803",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.