Provider Demographics
NPI:1518290329
Name:O'NEIL, MICHAEL JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:O'NEIL
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 1:595 BAY ISLES RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LONGBOAT KEY
Mailing Address - State:FL
Mailing Address - Zip Code:34228-3145
Mailing Address - Country:US
Mailing Address - Phone:941-383-6400
Mailing Address - Fax:941-383-6435
Practice Address - Street 1:595 BAY ISLES RD
Practice Address - Street 2:SUITE 110
Practice Address - City:LONGBOAT KEY
Practice Address - State:FL
Practice Address - Zip Code:34228-3149
Practice Address - Country:US
Practice Address - Phone:941-383-6400
Practice Address - Fax:941-981-9190
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN185061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice