Healthcare Provider Details
I. General information
NPI: 1962341016
Provider Name (Legal Business Name): AHMED ALAN HARAJLI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/25/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21120 ALLEN RD STE 2
WOODHAVEN MI
48183-1694
US
IV. Provider business mailing address
21120 ALLEN RD STE 2
WOODHAVEN MI
48183-1694
US
V. Phone/Fax
- Phone: 313-550-4515
- Fax:
- Phone: 734-675-7124
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 2901602971 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: