Individual provider Active NPI

Dima Georges Khalife, DDS

  • Dentist
  • Ferndale, MI
National Provider Identifier
1447495635
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901019978 Issued in MI
Practice address
1010 Livernois St
Ferndale, MI 48220-3347
Phone
(248) 398-1900
Fax
(248) 398-1919
NPI assigned
Dec 2, 2008
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901019978 MI Primary

Addresses

Primary practice location

1010 Livernois St
Ferndale, MI 48220-3347

Mailing address

1010 Livernois St
Ferndale, MI 48220-3347
Phone (248) 819-1616

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
I20190626002421 MI Order and Referring Only - DentistPractitioner - Dentist 3476887357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dima Khalife DDS, PLC Current Accepting new patients
Dima G Khalife DDS PC Current Accepting new patients

Locations

1010 Livernois St
Ferndale, MI 48220
Phone (248) 398-1900

Organizations & group practices 2

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": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1447495635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 LIVERNOIS ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482203347",
            "telephone_number": "248-819-1616",
            "fax_number": "248-398-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LIVERNOIS ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482203347",
            "telephone_number": "248-398-1900",
            "fax_number": "248-398-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIFE",
        "first_name": "DIMA",
        "middle_name": "GEORGES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-02",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, MI

Sources for this page

Verify at the official NPI Registry.