Ennis Malik Bedair, BDS

Primary specialty

DentistTaxonomy code 122300000X

License

2952000370 Issued in MI

Practice address

1500 E. Medical Center Dr., Med Inn C213A
Ann Arbor, MI 48109

Phone

(734) 936-5950

Fax

(734) 232-5015

NPI assigned

Sep 14, 2017

Last updated

Sep 25, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Anas Malik Mohammed Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1689193278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E. MEDICAL CENTER DR., TOWSLEY CENTER G1218",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E. MEDICAL CENTER DR., MED INN C213A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48109",
            "telephone_number": "734-936-5950",
            "fax_number": "734-232-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDAIR",
        "first_name": "ENNIS",
        "middle_name": "MALIK",
        "credential": "BDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-14",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2952000370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANAS",
            "last_name": "MOHAMMED",
            "middle_name": "MALIK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margot Lynne Beckerman, AUD
• Emil Beckford
• Marguerite Eva Beckler, LMFT
• Mieke A Beckman, MSW
• Hayley Beckmann
• Noelle Kennedy Bedard, ATC
• Aarti Oza Bedi, M.D.
• Asheesh Bedi, MD
• Filip Bednar, MD
• Bedside Angel's Home Care, LLC

• Dentist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.