Provider Demographics
NPI:1316561640
Name:MCILWAIN, ANNA KIHM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:KIHM
Last Name:MCILWAIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MISS
Other - First Name:ANNA
Other - Middle Name:GRACE
Other - Last Name:KIHM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2221 CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2027
Mailing Address - Country:US
Mailing Address - Phone:919-880-4017
Mailing Address - Fax:
Practice Address - Street 1:2221 CHARLOTTE ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2027
Practice Address - Country:US
Practice Address - Phone:919-880-4017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist