Maya Soueidan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5315241561 Issued in MI

Practice address

47299 Five Mile Rd
Plymouth, MI 48170-3764

Phone

(734) 459-3200

NPI assigned

May 29, 2023

Last updated

Dec 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Maya Imad Awada Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Select Dental Group PLLC

  • Dental Clinic/Center
  • Plymouth, MI
  • NPI 1215181334
  NPD (past)

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

{
    "created_epoch": "1685318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1043903925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N MILDRED ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281729",
            "telephone_number": "313-663-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47299 FIVE MILE RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703764",
            "telephone_number": "734-459-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUEIDAN",
        "first_name": "MAYA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-29",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "5315241561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYA",
            "last_name": "AWADA",
            "middle_name": "IMAD",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patricia Ann Soriano
• Samantha Sorter
• Charlize Sorzano
• Emily Jean Soto, DPT
• Latoia Souder
• Soulstice Counseling, LLC
• Peter Sourour
• Roy South
• Southwest Home Health Care Holdings of San Antonio, LLC
• Theresa Southworth

• General Practice Dentistry in Plymouth, MI
• Providers in Plymouth, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.