Healthcare Provider Details

I. General information

NPI: 1851274732
Provider Name (Legal Business Name): MARK BISHARA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N UNIVERSITY AVE
ANN ARBOR MI
48109
US

IV. Provider business mailing address

17 MACKEY DRIVE
WHITBY ONTARIO
L1P1P5
CA

V. Phone/Fax

Practice location:
  • Phone: 734-763-3325
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: