Abraham Lawrence Azzouz, D.D.S.

Primary specialty

Dental AssistantTaxonomy code 126800000X

Practice address

24366 Grand River Ave
Suite 111
Detroit, MI 48219-3063

Phone

(313) 535-2273

Fax

(313) 535-5212

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

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

Practice roles

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.

• Grand River Family Dentistry P.C.

  • General Practice Dentistry
  • Detroit, MI
  • NPI 1467401141
  NPD (past) Authorized official

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710945308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24366 GRAND RIVER AVE",
            "address_2": "SUITE 111",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193063",
            "telephone_number": "313-535-2273",
            "fax_number": "313-535-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24366 GRAND RIVER AVE",
            "address_2": "SUITE 111",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193063",
            "telephone_number": "313-535-2273",
            "fax_number": "313-535-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZZOUZ",
        "first_name": "ABRAHAM",
        "middle_name": "LAWRENCE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015675",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902014138",
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA",
            "identifier": "15675",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3197750",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "873745",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "D800185",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Azuh, PH.D.
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• Oluchukwu Jessica Azumah
• Anna Tom Azuz
• Azza Ali PLLC
• Joseph Azzouz, DDS
• Lyna Azzouz
• Cassidy Azzow, PSYD
• B S Pannu MD PC
• B. Rooted Wellness

• Dental Assistant in Detroit, MI
• Providers in Detroit, MI by specialty
• Dental Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.