Healthcare Provider Details

I. General information

NPI: 1073437265
Provider Name (Legal Business Name): AMBANI AESTHETICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 S HURON PKWY
ANN ARBOR MI
48104-5151
US

IV. Provider business mailing address

455 EAST EISENHOWER PARKWAY SUITE 300, PMB1021
ANN ARBOR MI
48108
US

V. Phone/Fax

Practice location:
  • Phone: 734-274-9550
  • Fax: 734-407-8004
Mailing address:
  • Phone: 734-274-9550
  • Fax: 734-407-8004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHOSHANA WOO AMBANI
Title or Position: OWNER/LEAD PLASTIC SURGEON
Credential: MD
Phone: 734-274-9550