Healthcare Provider Details

I. General information

NPI: 1669928685
Provider Name (Legal Business Name): SAAD KHIZAR USMANI BDS, MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6460 N CANTON CENTER RD
CANTON MI
48187-2660
US

IV. Provider business mailing address

141 DORCHESTER AVE UNIT 314
BOSTON MA
02127-1834
US

V. Phone/Fax

Practice location:
  • Phone: 734-221-3189
  • Fax:
Mailing address:
  • Phone: 469-740-7773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2901600354
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number0401418397
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number2901600354
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number0401418397
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: