Healthcare Provider Details

I. General information

NPI: 1295649523
Provider Name (Legal Business Name): ISMAIL B. SENDI, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 N SAINT JOSEPH AVE STE C2
NILES MI
49120-2263
US

IV. Provider business mailing address

26545 AMERICAN DR
SOUTHFIELD MI
48034-6115
US

V. Phone/Fax

Practice location:
  • Phone: 800-395-3223
  • Fax: 248-620-6405
Mailing address:
  • Phone: 800-395-3223
  • Fax: 248-620-6405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: JILLIAN JONES
Title or Position: SR CREDENTIALING SPECIALIST
Credential: MS
Phone: 800-395-3223