Provider Demographics
NPI:1609420819
Name:MIKHEIL, MICHEL (DDS)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:
Last Name:MIKHEIL
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 1:3121 N PRESIDENT GEORGE BUSH HWY STE 113
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2753
Mailing Address - Country:US
Mailing Address - Phone:425-289-8864
Mailing Address - Fax:
Practice Address - Street 1:3121 N PRESIDENT GEORGE BUSH HWY STE 113
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2753
Practice Address - Country:US
Practice Address - Phone:425-289-8864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX355031223G0001X
MO2021011766122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223G0001XDental ProvidersDentistGeneral Practice