Healthcare Provider Details

I. General information

NPI: 1881370443
Provider Name (Legal Business Name): HUSSEIN A HAMKA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4870 W CLARK RD STE 201
YPSILANTI MI
48197-1104
US

IV. Provider business mailing address

6001 YINGER AVE
DEARBORN MI
48126-2025
US

V. Phone/Fax

Practice location:
  • Phone: 734-822-6856
  • Fax:
Mailing address:
  • Phone: 313-673-6845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901601786
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: