Healthcare Provider Details

I. General information

NPI: 1285711002
Provider Name (Legal Business Name): MARK A SAXEN DDS, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 TERRACE STREET, SUITE 3189
PITTSBURGH PA
15261-2523
US

IV. Provider business mailing address

3501 TERRACE STREET, SUITE 3189
PITTSBURGH PA
15261-2523
US

V. Phone/Fax

Practice location:
  • Phone: 412-648-9100
  • Fax: 412-383-7862
Mailing address:
  • Phone: 412-648-9100
  • Fax: 412-383-7862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number12009547
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number12009547
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License NumberDS022642L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: