Provider Demographics
NPI:1972660454
Name:SORIN, MARK (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:SORIN
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 1:1206 CAPTAIN ADAMS CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-4902
Mailing Address - Country:US
Mailing Address - Phone:757-464-1496
Mailing Address - Fax:
Practice Address - Street 1:9159 FRANKTOWN ROAD
Practice Address - Street 2:
Practice Address - City:FRANKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23354
Practice Address - Country:US
Practice Address - Phone:757-442-4819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010073041223P0221X
PA0197021223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry