Provider Demographics
NPI:1538261987
Name:QURAISHI, KHAIRUNNISA (DDS)
Entity type:Individual
Prefix:DR
First Name:KHAIRUNNISA
Middle Name:
Last Name:QURAISHI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37184 DEQUINORE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310
Mailing Address - Country:US
Mailing Address - Phone:586-978-2042
Mailing Address - Fax:586-978-2505
Practice Address - Street 1:37184 DEQUINORE RD
Practice Address - Street 2:FAMILY AND COSMETIC DENTISTRY
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310
Practice Address - Country:US
Practice Address - Phone:586-978-2042
Practice Address - Fax:586-978-2505
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI015822122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist