Fatima Mohamad Shukr, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901601253 Issued in MI

Practice address

1074 Jackson Crossing
Jackson, MI 49202

Phone

(517) 841-0000

NPI assigned

Jun 2, 2022

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

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

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 and National Provider Directory roles.

• Pro Dental Mi 1 PC

  • General Practice Dentistry
  • Jackson, MI
  • NPI 1437986700
  NPD
• D2 Dental of Michigan

  • General Practice Dentistry
  • Jackson, MI
  • NPI 1821420043
  NPD (past)

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1306585732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7319 OAKMAN BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261526",
            "telephone_number": "313-461-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1074 JACKSON CROSSING",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49202",
            "telephone_number": "517-841-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKR",
        "first_name": "FATIMA",
        "middle_name": "MOHAMAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devan Christene Showerman, AGACNP
• Felicia C Showerman, RN
• Joseph Melvin Showerman II, LLC
• Emily Shriner, PT
• Jeffrey H Shuhaiber, MD
• Hussein Mohamad Shukr, MD
• Barbara H Shumard, LMSW
• Karlie Renae Shumway, MD
• Rebekah Anne Shurboff
• Lauren Siciliano

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.