Provider Demographics
NPI:1588957799
Name:ELHAGE, CHADY AHMED (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CHADY
Middle Name:AHMED
Last Name:ELHAGE
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 1:4251 COOLIDGE HWY
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-1639
Mailing Address - Country:US
Mailing Address - Phone:248-547-3700
Mailing Address - Fax:
Practice Address - Street 1:4251 COOLIDGE HWY
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-1639
Practice Address - Country:US
Practice Address - Phone:248-547-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010203891223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral Practice