Healthcare Provider Details

I. General information

NPI: 1417649781
Provider Name (Legal Business Name): ALI JIHAD FARHAT DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 KINGSWAY CT STE 2
TRENTON MI
48183-1957
US

IV. Provider business mailing address

771 SAN REMO DR
WESTON FL
33326-4536
US

V. Phone/Fax

Practice location:
  • Phone: 734-676-5656
  • Fax: 734-675-3304
Mailing address:
  • Phone: 248-644-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901601821
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN27907
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: