MEDICARE: DR. JOHN MCANINCH DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	DN21319	FL
2	1223P0221X	Pediatric Dentistry	32792	TX

General Provider Information

NPI Number	:	1942661798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN MCANINCH DMD

Provider Business Mailing Address
First Line	:	2455 DUNSTAN ROAD
Second Line	:	APT 443
City	:	HOUSTON
State	:	TX
Zip	:	77005
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9355 KATY FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-1516
Country	:	US
Telephone Number	:	713-999-0919
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2016
Last Update Date	:	03/17/2018

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Directions to “ DR. JOHN MCANINCH DMD” Practice Location

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