Healthcare Provider Details

I. General information

NPI: 1679499586
Provider Name (Legal Business Name): MIRNA MIKA ARAFAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6053 ROCHESTER RD
TROY MI
48085-1303
US

IV. Provider business mailing address

22367 SANDALWOOD DR
MACOMB MI
48044-3095
US

V. Phone/Fax

Practice location:
  • Phone: 248-879-5858
  • Fax:
Mailing address:
  • Phone: 586-388-2505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901603200
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: