Provider Demographics
NPI:1336488667
Name:POMPEANI, MARK J (DDS)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:J
Last Name:POMPEANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22725 FAIRVIEW CENTER DR STE 150
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-3612
Mailing Address - Country:US
Mailing Address - Phone:440-716-7667
Mailing Address - Fax:
Practice Address - Street 1:22725 FAIRVIEW CENTER DR STE 150
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-3612
Practice Address - Country:US
Practice Address - Phone:440-716-7667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20018122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist