Provider Demographics
NPI:1811780430
Name:ABOUBAKR, FATMA A
Entity type:Individual
Prefix:
First Name:FATMA
Middle Name:A
Last Name:ABOUBAKR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2581 NICHOLS CT
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-9308
Mailing Address - Country:US
Mailing Address - Phone:757-977-2146
Mailing Address - Fax:
Practice Address - Street 1:2581 NICHOLS CT
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-9308
Practice Address - Country:US
Practice Address - Phone:757-977-2146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902020268124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist