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General NPI Number Information
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NPI Number | 1235535089
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Entity Type | Individual
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Provider Name | SHADI ALZAHRANI BDS
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Gender | Male
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Dates
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Enumeration Date | 11/06/2014
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 1500 E MEDICAL CENTER DRIVE FLOOR 1, RECEPTION A, ROOM 1904
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City | ANN ARBOR
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State | MI
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Zip | 48109-0312
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Country | US
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Telephone | 734-615-6095
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Fax | 734-764-3485
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Provider Business Mailing Address
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Address Line | 1515 HOSPITAL DRIVE G1218 TOWSLEY
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City | ANN ARBOR
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State | MI
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Zip | 48109-5222
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DRP1372
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 2951000644
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License Number State | MI
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