Healthcare Provider Details

I. General information

NPI: 1326881152
Provider Name (Legal Business Name): MARIE MIHYON OH DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20405 EXCHANGE ST STE 201
ASHBURN VA
20147-5934
US

IV. Provider business mailing address

1350 BELASCO VALLEY CIR
GREAT FALLS VA
22066-2243
US

V. Phone/Fax

Practice location:
  • Phone: 703-369-2200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401419023
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: