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NPI Code Detail

MEDICARE: FARDOUS DENTAL SERVICES

MEDICARE: FARDOUS DENTAL SERVICES
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1518755040
Entity Type Code : Organization
Provider Name (Legal Business Name) : FARDOUS DENTAL SERVICES
Provider Business Mailing Address
First Line : 3757 OAKRIDGE CT
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-9392
Country : US
Telephone Number : 313-414-6109
Fax Number :
Provider Business Practice Location Address
First Line : 24510 FORD RD
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-3110
Country : US
Telephone Number : 313-561-2100
Fax Number :
Authorized Official
Title or Position : GENERAL DENTIST
Name : DR. SAHAR A FARDOUS
Credential : DDS
Telephone Number : 313-414-6109
Provider Enumeration Date : 04/25/2025
Last Update Date : 04/25/2025

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Directions to “FARDOUS DENTAL SERVICES ” Practice Location

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