Fadi A Elayyan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901601250 Issued in MI

Practice address

4860 Washtenaw Ave Ste D
Ann Arbor, MI 48108-3401

Phone

(734) 999-9909

NPI assigned

Jul 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Dental House - Waterford, PLLC

  • Dentist
  • Waterford TWP, MI
  • NPI 1700418555
  NPD
• Dental House - West Bloomfield

  • Dental Clinic/Center
  • West Bloomfield, MI
  • NPI 1083312243
  NPD

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1669958674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 PRAIRIE VIEW RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481088678",
            "telephone_number": "708-415-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 WASHTENAW AVE STE D",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083401",
            "telephone_number": "734-999-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAYYAN",
        "first_name": "FADI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901601250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "2901601250",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaborate You Hair Lash Aesthetics LLC
• Melissa Anne Elafros, M.D. PH.D.
• Ameer Elaimy, MD
• Akeila Elam
• Winston A Elam, CHW
• Leana Mustafa Idris Elbashir, MBBS
• Gail Shantae Elder-Battle, NP
• Jacquelyn Elder, FNP-BC
• James Tilford Elder, M.D., PH.D.
• Mary Josephine Elder, PHARMD

• General Practice Dentistry in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.