Mariam Atisha, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901601479 Issued in MI

Practice address

33428 Five Mile Rd
Livonia, MI 48154-2860

Phone

(734) 427-7555

NPI assigned

Jul 7, 2022

Last updated

Aug 26, 2025By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Lifetime Dental Care of Michigan, P.C.

  dba Livonia Dental Care

  • General Practice Dentistry
  • Livonia, MI
  • NPI 1447836242
  NPD
• Dental Professionals of Michigan, P.C.

  dba Cosmetic Dentistry Institute

  • General Practice Dentistry
  • Troy, MI
  • NPI 1528131364
  NPD (past)
• Livonia Dental Care

  • Exclusive Provider Organization
  • Livonia, MI
  • NPI 1083884092
  NPD (past)

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1063145977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4144 MEADOW WAY",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483011214",
            "telephone_number": "248-764-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33428 FIVE MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481542860",
            "telephone_number": "734-427-7555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3415 Livernois Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480835063",
            "country_code": "US",
            "telephone_number": "248-519-1919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATISHA",
        "first_name": "MARIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901601479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taher Ata, MD
• Ibrahim Elias Atallah, LPC
• Jurgita Atanaskovski
• Athletico LTD (Athletico Physical Therapy)
• Candace Atisha, PA-C
• Donald Eugene Atkins, DC
• Atlas Durable Medical Equipment, Inc.
• Nadine Atoui, DDS
• Amanda Atterberry
• Jordan Marie Attisha, PA-C

• General Practice Dentistry in Livonia, MI
• Providers in Livonia, 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 Aug 26, 2025; 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.