Basic Information
| Provider Information | |||||||||
| NPI: | 1891179529 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAQVI | ||||||||
| FirstName: | RABIA | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26750 GRAND RIVER AVE | ||||||||
| Address2: | |||||||||
| City: | REDFORD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482401529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7343060561 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5620 FM 1960 RD W | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770694202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2818809469 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2015 | ||||||||
| LastUpdateDate: | 11/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 2901021624 | MI | N | Dental Providers | Dentist | 1223G0001X | 33124 | TX | Y | Dental Providers | Dentist | General Practice |
No ID Information.