Healthcare Provider Details

I. General information

NPI: 1366105538
Provider Name (Legal Business Name): MARIHAM MEKHAIL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2021
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1286 E WEST HWY
SILVER SPRING MD
20910-3242
US

IV. Provider business mailing address

1286 E WEST HWY
SILVER SPRING MD
20910-3242
US

V. Phone/Fax

Practice location:
  • Phone: 301-761-4489
  • Fax:
Mailing address:
  • Phone: 301-761-4489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number17597
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: