Active NPI
Michelle Elizabeth Mukhtar
- Dentist
- Southfield, MI
National Provider Identifier
1780502666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5315269040
- Practice address
- 20307 W 12 Mile Rd Ste 101
Southfield, MI 48076-5407 - Phone
- (248) 775-2358
- NPI assigned
- Jul 8, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 5315269040 | MI | Primary |
Addresses
Primary practice location
20307 W 12 Mile Rd Ste 101
Southfield, MI 48076-5407
Mailing address
140 Canterbury Rd
Bloomfield Hills, MI 48304-2916
Phone (248) 762-9365
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1783468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783468800000",
"number": "1780502666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 CANTERBURY RD",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483042916",
"telephone_number": "248-762-9365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20307 W 12 MILE RD STE 101",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480765407",
"telephone_number": "248-775-2358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKHTAR",
"first_name": "MICHELLE",
"middle_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-07-08",
"last_updated": "2026-07-08",
"certification_date": "2026-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "5315269040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.