Individual provider Active NPI

Majd Tarakji, D.D.S.

  • General Practice Dentistry
  • Southfield, MI
National Provider Identifier
1417028747
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901017471 Issued in MI
Practice address
24293 Telegraph Rd Ste 212
Southfield, MI 48034-7903
Phone
(248) 223-5639
Fax
(248) 223-5689
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 2901017471 MI Primary

Addresses

Primary practice location

24293 Telegraph Rd Ste 212
Southfield, MI 48034-7903

Mailing address

29150 Westmont CT
Farmington Hills, MI 48334-3156
Phone (248) 865-7851

Other identifiers 2

IdentifierTypeStateIssuer
D800438OtherMIBLUE CROSS BLUE SHEILD
4413591MedicaidMI

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
I20150819007751 MI Order and Referring Only - DentistPractitioner - Dentist 8628383643

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417028747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29150 WESTMONT CT",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343156",
            "telephone_number": "248-865-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24293 TELEGRAPH RD STE 212",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347903",
            "telephone_number": "248-223-5639",
            "fax_number": "248-223-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARAKJI",
        "first_name": "MAJD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS  BLUE SHEILD",
            "identifier": "D800438",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4413591",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.