Provider Demographics
NPI:1952958894
Name:ALQAWASMEH, SUHAIB (DDS, MS)
Entity type:Individual
Prefix:
First Name:SUHAIB
Middle Name:
Last Name:ALQAWASMEH
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-2134
Mailing Address - Country:US
Mailing Address - Phone:248-682-6010
Mailing Address - Fax:
Practice Address - Street 1:4025 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-2134
Practice Address - Country:US
Practice Address - Phone:248-682-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0329831223G0001X
MI29016015021223G0001X
MI29520007061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice