Individual provider Active NPI

Fadi Mousa-Aqrawi, DDS

  • General Practice Dentistry
  • Warren, MI
National Provider Identifier
1982434288
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901602337 Issued in MI
Practice address
31207 Ryan Rd
Warren, MI 48092-3761
Phone
(586) 553-9399
NPI assigned
Aug 2, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901602337 MI Primary

Addresses

Primary practice location

31207 Ryan Rd
Warren, MI 48092-3761

Mailing address

4777 Aspenwood Dr
Sterling Heights, MI 48314-2945
Phone (586) 636-5080

Other practice location 1

3939 17 Mile Rd
Sterling Heights, MI 48310-6834
Phone (586) 264-4240

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
2901602337MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Happy Tooth General Practice PastSince Aug 4, 2024 Accepting new patients
Sundus Marogy Hy LLC General Practice Past Accepting new patients
Marogy Hy PPLC Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1982434288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4777 ASPENWOOD DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483142945",
            "telephone_number": "586-636-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31207 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480923761",
            "telephone_number": "586-553-9399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3939 17 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483106834",
            "country_code": "US",
            "telephone_number": "586-264-4240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUSA-AQRAWI",
        "first_name": "FADI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901602337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.