Provider Demographics
NPI:1952306094
Name:DARLING, MICHAEL JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:DARLING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 BUTTERNUT ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13208-2372
Mailing Address - Country:US
Mailing Address - Phone:315-373-0187
Mailing Address - Fax:315-396-0310
Practice Address - Street 1:1423 BUTTERNUT ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13208-2372
Practice Address - Country:US
Practice Address - Phone:315-373-0187
Practice Address - Fax:315-396-0310
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0491691223G0001X
NY049169-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02166916Medicaid
NY1952306094Medicaid