MEDICARE: TIENKEN DENTAL INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	013348	MI

General Provider Information

NPI Number	:	1366569105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIENKEN DENTAL INC.

Provider Business Mailing Address
First Line	:	330 W TIENKEN RD
Second Line	:	SUITE B
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-4474
Country	:	US
Telephone Number	:	248-656-1505
Fax Number	:	248-656-8846

Provider Business Practice Location Address
First Line	:	330 W TIENKEN RD
Second Line	:	SUITE B
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-4474
Country	:	US
Telephone Number	:	248-656-1505
Fax Number	:	248-656-8846

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SHERIF EL-SAYD BADR
Credential	:	D.D.S.
Telephone Number	:	248-656-1505

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	08/22/2020

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