Individual provider Active NPI

Maha Bishara, DMD

  • General Practice Dentistry
  • Sterling Heights, MI
National Provider Identifier
1396773305
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018957 Issued in MI
Practice address
37734 Van Dyke Ave
Sterling Heights, MI 48312-1839
Phone
(582) 978-2100
Fax
(586) 978-7244
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901018957 MI Primary

Addresses

Primary practice location

37734 Van Dyke Ave
Sterling Heights, MI 48312-1839

Mailing address

5050 Schaefer Rd
Dearborn, MI 48126-3249
Phone (313) 582-8150

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141231002079 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4183947989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901018957MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Midwestern Dental of Sterling Heights General Practice Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396773305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263249",
            "telephone_number": "313-582-8150",
            "fax_number": "313-582-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37734 VAN DYKE AVE",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483121839",
            "telephone_number": "582-978-2100",
            "fax_number": "586-978-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHARA",
        "first_name": "MAHA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.