Individual provider Active NPI

Jehan Wakeem, DDS

  • Dentist
  • Saint Clair Shores, MI
National Provider Identifier
1952417784
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901016399 Issued in MI
Practice address
28130 Harper Avenue
Saint Clair Shores, MI 48081
Phone
(586) 773-4550
Fax
(586) 774-0176
NPI assigned
Aug 22, 2006
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901016399 MI Primary
General Practice Dentistry 1223G0001X 2901016399 MI

Addresses

Primary practice location

28130 Harper Avenue
Saint Clair Shores, MI 48081

Mailing address

28130 Harper Ave
Saint Clair Shores, MI 48081-1605
Phone (586) 773-4550

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
I20160127000925 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779886643

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901016399MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jehan Wakeem DDS PLLC PastSince Jan 5, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jwakeem1156813@direct.hfhs.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1952417784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28130 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811605",
            "telephone_number": "586-773-4550",
            "fax_number": "586-774-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28130 HARPER AVENUE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-773-4550",
            "fax_number": "586-774-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEEM",
        "first_name": "JEHAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016399",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901016399",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.