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General NPI Number Information
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NPI Number | 1407433139
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Entity Type | Individual
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Provider Name | MARK SAMEH NAGUIB MEKHAIL DDS
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Gender | Male
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Dates
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Enumeration Date | 03/27/2021
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 36050 DETROIT RD STE T
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City | AVON
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State | OH
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Zip | 44011-1685
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Country | US
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Telephone | 440-870-6486
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Fax |
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Provider Business Mailing Address
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Address Line | 11126 LIGHT GUARD LOOP
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City | MANASSAS
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State | VA
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Zip | 20109-7635
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Country | US
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Telephone | 703-870-6403
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401417854
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30.028237
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License Number State | OH
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