Provider Demographics
NPI:1407923659
Name:MARK J POMPEANI DDS INC
Entity type:Organization
Organization Name:MARK J POMPEANI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:PMPEANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-716-7667
Mailing Address - Street 1:22725 FAIRVIEW CENTER DR
Mailing Address - Street 2:#150
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126
Mailing Address - Country:US
Mailing Address - Phone:440-716-7667
Mailing Address - Fax:216-716-9950
Practice Address - Street 1:22725 FAIRVIEW CENTER DR
Practice Address - Street 2:#150
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126
Practice Address - Country:US
Practice Address - Phone:440-716-7667
Practice Address - Fax:216-716-9950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20018122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty