Healthcare Provider Details

I. General information

NPI: 1972427854
Provider Name (Legal Business Name): HANINE MOHAMAD FARHAT DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

18590 OUTER DR
DEARBORN MI
48128-1872
US

IV. Provider business mailing address

22760 OAK ST
DEARBORN MI
48128-1306
US

V. Phone/Fax

Practice location:
  • Phone: 313-406-9612
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number901602707
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: