Healthcare Provider Details

I. General information

NPI: 1831918523
Provider Name (Legal Business Name): HIBA USMAN BDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 10/09/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N UNIVERSITY AVE
ANN ARBOR MI
48109-1078
US

IV. Provider business mailing address

1330 N UNIVERSITY CT APT 2
ANN ARBOR MI
48104-1642
US

V. Phone/Fax

Practice location:
  • Phone: 734-489-9869
  • Fax:
Mailing address:
  • Phone: 734-489-9869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2952000861
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: