Heba Abuhussein, BDS
Individual provider Active NPI Periodontics · Ann Arbor, MI
NPI 1861722993 · NPPES record last updated Jan 13, 2010
Key facts
- NPI
- 1861722993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Periodontics 1223P0300X
- License
- 2901020056 (MI)
- Practice address
- 290 Columbus Dr
Ann Arbor, MI 48103-2791 - Phone
- (734) 883-6095
- NPI assigned
- Jan 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161128000161 | MI | Order and Referring Only - Dentist |
3971882499 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901020056 | MI | MD | Periodontist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 2901020056 | MI | Yes |
Addresses
Primary practice location
290 Columbus Dr
Ann Arbor, MI 48103-2791
Mailing address
290 Columbus Dr
Ann Arbor, MI 48103-2791
Phone (734) 883-6095
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.