Healthcare Provider Details

I. General information

NPI: 1386412583
Provider Name (Legal Business Name): SUHA ALJUNEIDI PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 DIXIE HWY
WATERFORD MI
48328-1806
US

IV. Provider business mailing address

2180 DIXIE HWY STE 100
WATERFORD MI
48328-1806
US

V. Phone/Fax

Practice location:
  • Phone: 386-852-0370
  • Fax:
Mailing address:
  • Phone: 248-749-5141
  • Fax: 248-749-5131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SUHA ALJUNEIDI
Title or Position: PEDIATRIC DENTIST
Credential: DDS
Phone: 248-749-5141