Provider Demographics
NPI:1447709662
Name:RHEBI, WALEED
Entity type:Individual
Prefix:
First Name:WALEED
Middle Name:
Last Name:RHEBI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22330 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1468
Mailing Address - Country:US
Mailing Address - Phone:267-288-8984
Mailing Address - Fax:
Practice Address - Street 1:25523 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:CENTER LINE
Practice Address - State:MI
Practice Address - Zip Code:48015-1824
Practice Address - Country:US
Practice Address - Phone:586-757-5454
Practice Address - Fax:586-757-4147
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010220991223P0300X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics