# DINA ELHOUT DDS PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Center for Modern Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790216315
- **Authorized official:** YASSER ALALI DDS (DENTIST/OWNER)
- **Authorized official phone:** (313) 563-6601

## Contact information

- **Practice address:** 430 N TELEGRAPH RD, DEARBORN, MI 48128-1619
- **Practice address phone:** (313) 563-6601
- **Practice address fax:** (313) 563-6986
- **Mailing address:** 430 N TELEGRAPH RD, DEARBORN, MI 48128-1619
- **Mailing address phone:** (313) 563-6601
- **Mailing address fax:** (313) 563-6986

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901021238 | MI | — |
| 1223P0300X | Periodontics | 2901021098 | MI | — |
| 1223P0700X | Prosthodontics | 2901020729 | MI | Yes |

## Other

- **Enumeration date:** 03/24/2017
- **Last updated:** 03/24/2017