Brandon Sam Khaddor, D.D.S.

General Practice Dentistry · New Haven, MI

Individual Active NPI

NPI number 1417649286

Practice location

59041 Gratiot Ave
New Haven, MI 48048-2057
Phone
(586) 749-3333

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NPI record

NPI
1417649286
Entity type
Individual (Type 1)
Enumeration date
May 22, 2023
Last updated
February 25, 2025
Certified
February 25, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 2901601643 MI

Mailing address

2564 Lorenzo Dr
Sterling Heights, MI 48314-4515
Phone
(586) 804-8118

About Dr. Khaddor

Brandon Sam Khaddor, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 59041 Gratiot Ave, New Haven, MI 48048-2057. The NPI number 1417649286 was assigned on May 22, 2023 and the record was last updated on February 25, 2025.

Dr. Khaddor lists a license in the registry: #2901601643 (MI) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Brandon Sam Khaddor, D.D.S.?

The NPI number is 1417649286.

What is the phone number of Dr. Khaddor?

The phone number listed for the practice location is (586) 749-3333.

Where is Dr. Khaddor located?

59041 Gratiot Ave, New Haven, MI 48048-2057.

What is the taxonomy code for Dr. Khaddor?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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