Individual
DR. FADI A ELAYYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4860 WASHTENAW AVE STE D, ANN ARBOR, MI 48108-3401
(734) 999-9909
Mailing address
2824 PRAIRIE VIEW RD, ANN ARBOR, MI 48108-8678
(708) 415-4126
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901601250
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901601250
DENTAL LICENSE
MI
Enumeration date
07/12/2018
Last updated
03/27/2025
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