Healthcare Provider Details

I. General information

NPI: 1306536263
Provider Name (Legal Business Name): MOHAMED HARAJLI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N TELEGRAPH RD
DEARBORN MI
48128-1658
US

IV. Provider business mailing address

26088 WILSON DR
DEARBORN HEIGHTS MI
48127-4151
US

V. Phone/Fax

Practice location:
  • Phone: 313-524-1413
  • Fax:
Mailing address:
  • Phone: 313-912-2741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number5315269894
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: