Healthcare Provider Details

I. General information

NPI: 1700545779
Provider Name (Legal Business Name): KAHANA OCULOPLASTIC SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 7 MILE RD STE 2400
LIVONIA MI
48152-1006
US

IV. Provider business mailing address

39000 7 MILE RD STE 2400
LIVONIA MI
48152-1006
US

V. Phone/Fax

Practice location:
  • Phone: 248-800-1177
  • Fax: 248-800-1178
Mailing address:
  • Phone: 248-800-1177
  • Fax: 248-800-1178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALON KAHANA
Title or Position: ATTENDING SURGEON
Credential: M.D., PH.D.
Phone: 248-800-1177