Provider Demographics
NPI:1285711002
Name:SAXEN, MARK A (DDS, PHD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:SAXEN
Suffix:
Gender:M
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 TERRACE STREET, SUITE 3189
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15261-2523
Mailing Address - Country:US
Mailing Address - Phone:412-648-9100
Mailing Address - Fax:412-383-7862
Practice Address - Street 1:3501 TERRACE STREET, SUITE 3189
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-2523
Practice Address - Country:US
Practice Address - Phone:412-648-9100
Practice Address - Fax:412-383-7862
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009547122300000X, 1223D0004X
PADS022642L1223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177477001Medicaid
IN200800900Medicaid
INU67459Medicare UPIN