Sheikh Muhammad Mamoon – General Practice Dentistry

Key facts

NPI: 1124850292
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 2901602312 (MI)
Practice address: 348 Wilson Ave NW
Walker, MI 49534-3555
Phone: (616) 317-2485
NPI assigned: Aug 17, 2024
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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

Lifetime Dental Care of Michigan, P.C. General Practice Dentistry · Walker, MI · NPI 1811672199

NPD GENERAL PRACTICE

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
2901602312	MI	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Lifetime Dental Care of Michigan, P.C.	General Practice	Current since Aug 18, 2024	Accepting new patients

Locations

348 Wilson Ave NW
Walker, MI 49534
Phone (616) 317-2485

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	2901602312	MI	Yes

Addresses

Primary practice location

348 Wilson Ave NW
Walker, MI 49534-3555

Mailing address

1687 Emerald Pines Dr
Canton, MI 48188-2236
Phone (734) 331-5027

Other providers in Walker, MI

All providers in Walker, MI · General Practice Dentistry in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.