Active NPI
Marian Hannah Ibrahim, D.D.S.
- Dentist
- Lathrup Village, MI
National Provider Identifier
1295353829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901600579
- Practice address
- 19189 W 12 Mile Rd
Lathrup Village, MI 48076 - Phone
- (248) 855-1855
- NPI assigned
- Jul 9, 2020
- Sex
- Female
- 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 | 2901600579 | MI | Primary |
Addresses
Primary practice location
19189 W 12 Mile Rd
Lathrup Village, MI 48076
Mailing address
7118 Timberview TRL
West Bloomfield, MI 48322-3343
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 |
|---|---|---|---|
| 2901600579 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594252800000",
"number": "1295353829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7118 TIMBERVIEW TRL",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483223343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19189 W 12 MILE RD",
"city": "LATHRUP VILLAGE",
"state": "MI",
"postal_code": "48076",
"telephone_number": "248-855-1855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "MARIAN",
"middle_name": "HANNAH",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-09",
"last_updated": "2020-07-09",
"certification_date": "2020-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901600579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lathrup Village, MI
- Helping Hands Private Care Services LLC (Helping Hands Priivate Care & Respite Services)
- Hematology and Oncology Center, PC
- Heritage Home Health Care Inc.
- Laquita Hill
- Alberto Hodari, M.D.
- Infinity Rehab of Mi LLC
- Integrated Home Care, Inc.
- Faustina Ifeoma Iroha
- James T Gilas M.D. Spine and Joint Center PLLC
- Jamie L Bodenhafer LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.