Provider Demographics
NPI:1427755693
Name:HAQ, MEHAK GUL (DDS)
Entity type:Individual
Prefix:DR
First Name:MEHAK
Middle Name:GUL
Last Name:HAQ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6583 WHISPERING WOODS DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-5201
Mailing Address - Country:US
Mailing Address - Phone:248-978-4358
Mailing Address - Fax:
Practice Address - Street 1:7310 WALTON ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-4614
Practice Address - Country:US
Practice Address - Phone:815-395-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-08
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601611122300000X
390200000X
IL019.034104122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program