Provider Demographics
NPI:1982305330
Name:BABKIR, SHUKRAN
Entity type:Individual
Prefix:
First Name:SHUKRAN
Middle Name:
Last Name:BABKIR
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 1:1301 CATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-2026
Mailing Address - Country:US
Mailing Address - Phone:734-936-3568
Mailing Address - Fax:
Practice Address - Street 1:1301 CATHERINE ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-2026
Practice Address - Country:US
Practice Address - Phone:734-936-3568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2025-08-26
Deactivation Date:2025-07-08
Deactivation Code:
Reactivation Date:2025-08-13
Provider Licenses
StateLicense IDTaxonomies
MI2901602489122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program