Healthcare Provider Details

I. General information

NPI: 1730007915
Provider Name (Legal Business Name): MAKHZAN ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 ALABAMA RD NE STE 154
ROSWELL GA
30075-1622
US

IV. Provider business mailing address

4750 ALABAMA RD NE STE 154
ROSWELL GA
30075-1622
US

V. Phone/Fax

Practice location:
  • Phone: 470-231-9460
  • Fax:
Mailing address:
  • Phone: 470-231-9460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. YASEEN MAKHZAN
Title or Position: ORTHODONTIST
Credential: DMD
Phone: 407-718-8699