Provider Demographics
NPI:1992761530
Name:ALBAGHDADI, ADIL JADOO I (DMD)
Entity type:Individual
Prefix:DR
First Name:ADIL
Middle Name:JADOO
Last Name:ALBAGHDADI
Suffix:I
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31515 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4528
Mailing Address - Country:US
Mailing Address - Phone:586-294-0900
Mailing Address - Fax:586-294-0903
Practice Address - Street 1:31515 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4528
Practice Address - Country:US
Practice Address - Phone:586-294-0900
Practice Address - Fax:586-294-0903
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010175481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice