Individual provider Active NPI

Al Baraa Abdul Khalek, DDS

  • Dentist
  • Farmington Hills, MI
National Provider Identifier
1740919968
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901601355 Issued in MI
Practice address
33966 W 8 Mile Rd Ste 104
Farmington Hills, MI 48335-5273
Phone
(248) 474-6434
NPI assigned
Jun 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 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 2901601355 MI Primary

Addresses

Primary practice location

33966 W 8 Mile Rd Ste 104
Farmington Hills, MI 48335-5273

Mailing address

26977 Havelock Dr
Dearborn Heights, MI 48127-3688
Phone (734) 747-0569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901601355MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Comfort Dental Group PLLC PastSince Jun 21, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1740919968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26977 HAVELOCK DR",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273688",
            "telephone_number": "734-747-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33966 W 8 MILE RD STE 104",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483355273",
            "telephone_number": "248-474-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDUL KHALEK",
        "first_name": "AL BARAA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.