Abraham Lawrence Azzouz, DDS is a medicare enrolled "Dental Assistant" provider in Detroit, Michigan. His current practice location is
24366 Grand River Ave, Suite 111, Detroit, Michigan. You can reach out to his office (for appointments etc.) via phone at
(313) 535-2273.
Abraham Lawrence Azzouz is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1710945308.
Healthcare Provider's Profile
Full Name | Abraham Lawrence Azzouz |
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Gender | Male |
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Speciality | Dental Assistant |
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Location | 24366 Grand River Ave, Detroit, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1710945308
- Provider Enumeration Date: 05/03/2006
- Last Update Date: 03/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 5799004495
- Enrollment ID: I20150430001966
Medical Identifiers
Medical identifiers for Abraham Lawrence Azzouz such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1710945308 | NPI | - | NPPES |
15675 | Other | MI | DELTA |
3197750 | Medicaid | MI | |
873745 | Other | | UNITED CONCORDIA |
D800185 | Other | MI | BLUE CROSS BLUE SHEILD |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 2901015675 (Michigan) | Primary |
124Q00000X | Dental Hygienist | 2902014138 (Michigan) | Primary |
126800000X | Dental Assistant | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Abraham Lawrence Azzouz is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Abraham Lawrence Azzouz, DDS 24366 Grand River Ave, Suite 111, Detroit, MI 48219-3063 Ph: (313) 535-2273 | Abraham Lawrence Azzouz, DDS 24366 Grand River Ave, Suite 111, Detroit, MI 48219-3063 Ph: (313) 535-2273 |
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