Healthcare Provider Details

I. General information

NPI: 1538726757
Provider Name (Legal Business Name): ALYSSA MARIE MUGHAL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 CLAIREDAN DR
POWELL OH
43065-8064
US

IV. Provider business mailing address

39 CLAIREDAN DR
POWELL OH
43065-8064
US

V. Phone/Fax

Practice location:
  • Phone: 614-436-4433
  • Fax:
Mailing address:
  • Phone: 614-361-2998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.028245
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: