Provider Demographics
NPI:1316438666
Name:KHOURY, RAMMIZ J (DMD)
Entity type:Individual
Prefix:DR
First Name:RAMMIZ
Middle Name:J
Last Name:KHOURY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:RAYZ
Other - Middle Name:J
Other - Last Name:KHOURY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:38117 LORDSTOWN DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-1641
Mailing Address - Country:US
Mailing Address - Phone:615-569-8900
Mailing Address - Fax:
Practice Address - Street 1:6203 MILLER RD STE A
Practice Address - Street 2:
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-1597
Practice Address - Country:US
Practice Address - Phone:810-635-8446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI2901600232122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program