Provider Demographics
NPI:1588338263
Name:ABI HUSSEIN, REEM (DDS)
Entity type:Individual
Prefix:
First Name:REEM
Middle Name:
Last Name:ABI HUSSEIN
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 1:770 KENMOOR AVE SE STE 200
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8621
Mailing Address - Country:US
Mailing Address - Phone:504-508-6319
Mailing Address - Fax:
Practice Address - Street 1:770 KENMOOR AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8621
Practice Address - Country:US
Practice Address - Phone:504-508-6319
Practice Address - Fax:616-320-2951
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016010701223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics