Atheer Fawzi-Jassim, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901600140 Issued in MI

Practice address

26401 Harper Ave
Saint Clair Shores, MI 48081-1905

Phone

(586) 804-7171

NPI assigned

Jun 27, 2019

Sex

Male

Sole proprietor

Yes

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.

• All Dental 2 PLLC

  • Dental Clinic/Center
  • Clinton TWP, MI
  • NPI 1922864396
  NPD Authorized official
• All Dental Warren PLLC

  • Dental Clinic/Center
  • Warren, MI
  • NPI 1427842723
  NPD Authorized official
• All Dental PLLC

  • Dental Clinic/Center
  • Saint Clair Shores, MI
  • NPI 1669194213
  NPD
• Amazing Dental PLLC

  • Dental Clinic/Center
  • Southfield, MI
  • NPI 1275018087
  NPD (past)

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1194386391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 FORT ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923545",
            "telephone_number": "734-444-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26401 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811905",
            "telephone_number": "586-804-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWZI-JASSIM",
        "first_name": "ATHEER",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Excell Rehab Inc
• Exclusive Physicians PLLC
• Exodus Hair & Nail Studio LLC
• Mahmoud A-M Farea
• Raymond J Farrar
• Anthony Fazi, NP
• Renee Fedorinchik, PT
• Anthony F Femminineo, MD
• Dominic Femminineo, D.O.
• Joseph P Femminineo, MD

• Dentist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.