Provider Demographics
NPI:1194265652
Name:TARAJI, WASEEM M (DMD)
Entity type:Individual
Prefix:DR
First Name:WASEEM
Middle Name:M
Last Name:TARAJI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44627 MOUND RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1321
Mailing Address - Country:US
Mailing Address - Phone:586-323-7201
Mailing Address - Fax:
Practice Address - Street 1:44627 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-1321
Practice Address - Country:US
Practice Address - Phone:586-323-7201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016021631223G0001X
OH30.0255141223G0001X
IN12013070A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice