Provider Demographics
NPI:1932838687
Name:MCNINCH, MICHAEL SYL (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SYL
Last Name:MCNINCH
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 1:9116 QUIET COVE WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3362
Mailing Address - Country:US
Mailing Address - Phone:702-328-0752
Mailing Address - Fax:
Practice Address - Street 1:223 N PECOS RD STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7362
Practice Address - Country:US
Practice Address - Phone:702-734-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV76391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice