MEDICARE: DR. REEM ALABBOUSI DDS

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	18288	OH
2	1223G0001X	General Practice Dentistry	2901018288	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588776975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REEM ALABBOUSI DDS

Provider Business Mailing Address
First Line	:	25711 W WARREN ST
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-2046
Country	:	US
Telephone Number	:	313-565-1862
Fax Number	:	313-562-5428

Provider Business Practice Location Address
First Line	:	25711 W WARREN ST
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-2046
Country	:	US
Telephone Number	:	313-565-1862
Fax Number	:	313-562-5428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	08/02/2021

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