Individual provider Active NPI

Mariann Ghaly, DMD

  • General Practice Dentistry
  • Corinth, TX
National Provider Identifier
1104346790
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10707 Issued in NC
Practice address
3504 Corinth Pkwy Ste 120
Corinth, TX 76208-1316
Phone
(940) 498-2290
NPI assigned
Jun 23, 2017
Last updated
Jan 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10707 NC Primary

Addresses

Primary practice location

3504 Corinth Pkwy Ste 120
Corinth, TX 76208-1316

Mailing address

417 Front Nine Ave
Allen, TX 75002-1770

Other practice location 1

3450 Forestdale Dr
Burlington, NC 27215
Phone (336) 226-0855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181018001830 TN Order and Referring Only - DentistPractitioner - Dentist 0840543930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Loretto Family Dentistry General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1104346790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 FRONT NINE AVE",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750021770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 CORINTH PKWY STE 120",
            "city": "CORINTH",
            "state": "TX",
            "postal_code": "762081316",
            "telephone_number": "940-498-2290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3450 Forestdale Dr",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NC",
            "postal_code": "27215",
            "country_code": "US",
            "telephone_number": "336-226-0855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHALY",
        "first_name": "MARIANN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, TX

Sources for this page

Verify at the official NPI Registry.