Individual provider Active NPI

Muad Mohamed A Suleiman

  • Dentist
  • Detroit, MI
National Provider Identifier
1881179752
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901601938 Issued in MI
Practice address
2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576
Phone
(313) 494-6700
NPI assigned
Sep 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X DL13777 MA
Dentist 122300000X 2901601938 MI Primary

Addresses

Primary practice location

2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576

Mailing address

7394 Central St Apt 2
Westland, MI 48185-2552

Other identifiers 1

IdentifierTypeStateIssuer
04-2103547OtherMAHENRY M GOLDMAN SCHOOL OF DENTAL MEDICINE

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
2901601938MIMDDentist
DL13777MAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1881179752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7394 CENTRAL ST APT 2",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481852552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082576",
            "telephone_number": "313-494-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULEIMAN",
        "first_name": "MUAD MOHAMED",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-26",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "DL13777",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HENRY M GOLDMAN SCHOOL OF DENTAL MEDICINE",
            "identifier": "04-2103547",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.