Active NPI
Dolly Jean Gharib, D.D.S
- General Practice Dentistry
- Dearborn, MI
National Provider Identifier
1770890287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901020285
- Practice address
- 117 Lake Village Blvd
Apt. 303
Dearborn, MI 48120-1653 - Phone
- (519) 903-0530
- NPI assigned
- Sep 3, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901020285 | MI | Primary |
Addresses
Primary practice location
117 Lake Village Blvd
Apt. 303
Dearborn, MI 48120-1653
Mailing address
2412 Meldrum Rd.
Windsor, ONTARIO N8W4E8
CA
Phone (519) 903-0530
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2901020285 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283472000000",
"number": "1770890287",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "2412 MELDRUM RD.",
"city": "WINDSOR",
"state": "ONTARIO",
"postal_code": "N8W4E8",
"telephone_number": "519-903-0530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 LAKE VILLAGE BLVD",
"address_2": "APT. 303",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481201653",
"telephone_number": "519-903-0530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHARIB",
"first_name": "DOLLY",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-03",
"last_updated": "2010-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901020285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.