Provider Demographics
NPI:1306533831
Name:YONAN, SAMER ADNAN SR (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMER
Middle Name:ADNAN
Last Name:YONAN
Suffix:SR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43991 RUSHCLIFFE DR # 159
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1198
Mailing Address - Country:US
Mailing Address - Phone:602-405-2658
Mailing Address - Fax:
Practice Address - Street 1:22010 EUREKA RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-5233
Practice Address - Country:US
Practice Address - Phone:313-766-0111
Practice Address - Fax:734-287-1140
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI2901601707122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program