Provider Demographics
NPI:1366683120
Name:MC NAIR, LARRY FERNANDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:FERNANDO
Last Name:MC NAIR
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 1:2033 HAMLIN ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2453
Mailing Address - Country:US
Mailing Address - Phone:202-526-2902
Mailing Address - Fax:202-526-8068
Practice Address - Street 1:2033 HAMLIN ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2453
Practice Address - Country:US
Practice Address - Phone:202-526-2902
Practice Address - Fax:202-829-4655
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN44851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice