=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215851480
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TKN DENTAL, P.C
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2026
-----------------------------------------------------
Last Update Date | 08/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2130 S TELEGRAPH RD
-----------------------------------------------------
City | BLOOMFIELD HILLS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48302-0259
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-860-6863
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2130 S TELEGRAPH RD
-----------------------------------------------------
City | BLOOMFIELD HILLS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48302-0259
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-860-6863
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | DR. TABITHA SALAM NAIMI
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 248-860-6863
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------