Individual provider Active NPI

Jade Mourad

  • Dentist
  • Shelby Township, MI
National Provider Identifier
1154111920
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2951000996 Issued in MI
Practice address
8136 21 Mile Rd
Shelby Township, MI 48317-4312
Phone
(586) 726-2273
NPI assigned
May 7, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2951000996 MI Primary

Addresses

Primary practice location

8136 21 Mile Rd
Shelby Township, MI 48317-4312

Mailing address

800 Michaux LN
Grosse Pointe Shores, MI 48236-1401

Other practice location 1

51190 D W Seaton Dr
Chesterfield, MI 48047-1457
Phone (586) 725-9898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250708000951 MI Order and Referring Only - DentistPractitioner - Dentist 4981118452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: jmourad598477@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1154111920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MICHAUX LN",
            "city": "GROSSE POINTE SHORES",
            "state": "MI",
            "postal_code": "482361401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8136 21 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483174312",
            "telephone_number": "586-726-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51190 D W Seaton Dr",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MI",
            "postal_code": "480471457",
            "country_code": "US",
            "telephone_number": "586-725-9898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOURAD",
        "first_name": "JADE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-07",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2951000996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.