Provider Demographics
NPI:1962552075
Name:MAJED, MOHAMAD HASSAN (DDS)
Entity type:Individual
Prefix:MR
First Name:MOHAMAD
Middle Name:HASSAN
Last Name:MAJED
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15600 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2944
Mailing Address - Country:US
Mailing Address - Phone:313-584-6900
Mailing Address - Fax:313-584-1552
Practice Address - Street 1:15600 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2944
Practice Address - Country:US
Practice Address - Phone:313-584-6900
Practice Address - Fax:313-584-1552
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI015998122300000X
AZD6887122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2978807Medicaid