Provider Demographics
NPI:1396352175
Name:SINJAB, KHALED (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:KHALED
Middle Name:
Last Name:SINJAB
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30084 FOX CLUB DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1928
Mailing Address - Country:US
Mailing Address - Phone:248-949-4349
Mailing Address - Fax:
Practice Address - Street 1:8641 W GRAND RIVER AVE STE 8
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-4330
Practice Address - Country:US
Practice Address - Phone:734-763-3325
Practice Address - Fax:810-220-4935
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016007041223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty