Individual provider Active NPI

Faith M Aboona, DDS

  • Dentist
  • Washington, MI
National Provider Identifier
1336404979
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020756 Issued in MI
Practice address
64845 Van Dyke Rd
#3
Washington, MI 48095-2836
Phone
(586) 752-6596
Fax
(586) 752-5471
NPI assigned
Jul 10, 2012
Last updated
Aug 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020756 MI Primary

Addresses

Primary practice location

64845 Van Dyke Rd
#3
Washington, MI 48095-2836

Mailing address

49202 E Woods Dr
Shelby Township, MI 48317-1850
Phone (248) 854-0618

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200423003066 MI Practitioner - Oral SurgeryPractitioner - DentistPractitioner - Sleep MedicinePractitioner - General Practice 5597195065 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Family Dentistry PLLC Dentist CurrentSince Mar 5, 2020 Accepting new patients

Locations

11899 Vista Springs Blvd
Washington, MI 48095
Phone (586) 752-6596

64845 Van Dyke Rd
Ste 3
Washington, MI 48095
Phone (586) 752-6596

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1336404979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49202 E WOODS DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483171850",
            "telephone_number": "248-854-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64845 VAN DYKE RD",
            "address_2": "#3",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480952836",
            "telephone_number": "586-752-6596",
            "fax_number": "586-752-5471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOONA",
        "first_name": "FAITH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MI

Sources for this page

Verify at the official NPI Registry.