Individual provider Active NPI

Ahmed Tawfik El-Mahrouky, DDS

  • Dentist
  • Warren, MI
National Provider Identifier
1760603203
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901018474 Issued in MI
Practice address
11552 East 12 Mile Road
Warren, MI 48093
Phone
(586) 573-7500
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901018474 MI Primary

Addresses

Primary practice location

11552 East 12 Mile Road
Warren, MI 48093

Mailing address

11552 East 12 Mile Road
Warren, MI 48093
Phone (586) 573-7500

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
I20160916001027 MI Order and Referring Only - DentistPractitioner - Dentist 2668769753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760603203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11552 EAST 12 MILE ROAD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11552 EAST 12 MILE ROAD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-MAHROUKY",
        "first_name": "AHMED",
        "middle_name": "TAWFIK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.