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General NPI Number Information
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NPI Number | 1457279762
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Entity Type | Individual
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Provider Name | JOE BERJAOUI DDS
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Gender | Male
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 139 W LAKE LANSING RD STE 200
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City | EAST LANSING
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State | MI
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Zip | 48823-8540
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Country | US
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Telephone | 517-541-4530
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Fax |
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Provider Business Mailing Address
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Address Line | 7444 THEISEN ST
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City | DEARBORN
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State | MI
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Zip | 48126-1652
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Country | US
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Telephone | 313-929-1000
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901603131
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License Number State | MI
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