Active NPI
Ali Khanafer, DDS
- Dentist
- Warren, MI
National Provider Identifier
1194569574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901602085
- Practice address
- 28282 Dequindre Rd
Warren, MI 48092-5604 - Phone
- (586) 574-2620
- NPI assigned
- Jun 21, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901602085 | MI | Primary |
Addresses
Primary practice location
28282 Dequindre Rd
Warren, MI 48092-5604
Mailing address
1635 Rankin Avenue
Windsor, ONTARIO N9B 3R3
CA
Other practice location 1
18181 W 12 Mile Rd
Lathrup Village, MI 48076-2666
Phone (248) 557-5756
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901602085 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifetime Dental Care of Michigan, P.C. | Current | Accepting new patients | |
| Universal Dental Group P.L.L.C. | Dentist | Current | Accepting new patients |
| Jeffrey M. Solomon DDS PC | Past | Accepting new patients |
Locations
28282 Dequindre Rd
Warren, MI 48092
Phone (586) 574-2620
Organizations & group practices 3
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.
-
- General Practice Dentistry
- Warren, MI
- NPI 1477261329
-
- Dentist
- Warren, MI
- NPI 1114041266
-
- General Practice Dentistry
- Lathrup Village, MI
- NPI 1801045828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1194569574",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "1635 RANKIN AVENUE",
"city": "WINDSOR",
"state": "ONTARIO",
"postal_code": "N9B 3R3"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28282 DEQUINDRE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480925604",
"telephone_number": "586-574-2620"
}
],
"practiceLocations": [
{
"address_1": "18181 W 12 Mile Rd",
"address_purpose": "LOCATION",
"city": "Lathrup Village",
"state": "MI",
"postal_code": "480762666",
"country_code": "US",
"telephone_number": "248-557-5756",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHANAFER",
"first_name": "ALI",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-21",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901602085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.