Provider Demographics
NPI:1720175946
Name:KEVIN Y. MYINT, DDS
Entity Type:Organization
Organization Name:KEVIN Y. MYINT, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:MYINT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-398-9500
Mailing Address - Street 1:2939 AIRDRIE AVE
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-2422
Mailing Address - Country:US
Mailing Address - Phone:410-569-0918
Mailing Address - Fax:410-398-0427
Practice Address - Street 1:121 BIG ELK MALL
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5912
Practice Address - Country:US
Practice Address - Phone:410-398-9500
Practice Address - Fax:410-398-0427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12530122300000X
MD124611223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty