Provider Demographics
NPI:1801988571
Name:NAKHLEH, MAZIN (DDS)
Entity type:Individual
Prefix:DR
First Name:MAZIN
Middle Name:
Last Name:NAKHLEH
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 1:11520 N CENTRAL EXPY
Mailing Address - Street 2:#220
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6605
Mailing Address - Country:US
Mailing Address - Phone:214-340-9696
Mailing Address - Fax:214-340-0413
Practice Address - Street 1:11520 N CENTRAL EXPY
Practice Address - Street 2:#220
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6605
Practice Address - Country:US
Practice Address - Phone:214-340-9696
Practice Address - Fax:214-340-0413
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX152581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice