Provider Demographics
NPI:1699469460
Name:ALBISHARA, MESHLEEN (DMD)
Entity type:Individual
Prefix:
First Name:MESHLEEN
Middle Name:
Last Name:ALBISHARA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15109 VINO ROSA CT
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-4441
Mailing Address - Country:US
Mailing Address - Phone:586-553-1114
Mailing Address - Fax:
Practice Address - Street 1:5601 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-3810
Practice Address - Country:US
Practice Address - Phone:517-882-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601843122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist