Moufida A Khalife, DDS, MS

Primary specialty

DentistTaxonomy code 122300000X

License

2901019252 Issued in MI

Practice address

47299 Five Mile Rd
Plymouth, MI 48170-3764

Phone

(734) 459-3200

Fax

(734) 459-1995

NPI assigned

Oct 31, 2006

Last updated

Apr 10, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Moufida Masri Khalife Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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) Authorized official

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1164508099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9075 STONE HOLLOW CT",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "48170",
            "telephone_number": "734-459-3200"
        },
        {
            "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",
            "fax_number": "734-459-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIFE",
        "first_name": "MOUFIDA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164508099",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOUFIDA",
            "last_name": "KHALIFE",
            "middle_name": "MASRI",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joelen Elizabeth Kersten, LLMSW, CAADC
• Amanda Rose Kertesz, MA, BCBA, LBA
• Kevin Rose PLLC
• Austin Keyser
• Luba Khakham
• Bismah Jamshed Khan, MA, TLLP
• Hussain Khan
• Mohammad Khan
• Nadia Khan
• Parvej Khan, D.P.T

• Dentist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.