Provider Demographics
NPI:1275377145
Name:VINEYARDS DENTAL & IMPLANTS PLLC
Entity type:Organization
Organization Name:VINEYARDS DENTAL & IMPLANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBWAR
Authorized Official - Middle Name:SAMEER
Authorized Official - Last Name:RAHEEMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-879-3231
Mailing Address - Street 1:4455 VINEYARDS BLVD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1842
Mailing Address - Country:US
Mailing Address - Phone:586-879-3231
Mailing Address - Fax:
Practice Address - Street 1:43060 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-2018
Practice Address - Country:US
Practice Address - Phone:586-879-3231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental