Provider Demographics
NPI:1306337472
Name:ALAZAWI, SHIEM (DDS)
Entity type:Individual
Prefix:DR
First Name:SHIEM
Middle Name:
Last Name:ALAZAWI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18370 OUTER DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1353
Mailing Address - Country:US
Mailing Address - Phone:313-502-7884
Mailing Address - Fax:
Practice Address - Street 1:2021 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2926
Practice Address - Country:US
Practice Address - Phone:313-565-5586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901022612122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist