Provider Demographics
NPI:1285292490
Name:DABIRI, DONYA
Entity type:Individual
Prefix:DR
First Name:DONYA
Middle Name:
Last Name:DABIRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 MEADOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-3052
Mailing Address - Country:US
Mailing Address - Phone:734-486-5578
Mailing Address - Fax:
Practice Address - Street 1:19251 MACK AVE STE 220
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-2881
Practice Address - Country:US
Practice Address - Phone:313-343-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016010081223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry