Healthcare Provider Details

I. General information

NPI: 1992613236
Provider Name (Legal Business Name): MICAH D NAYLOR DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 N GENERALS BLVD STE F
LINCOLNTON NC
28092-3537
US

IV. Provider business mailing address

518 N GENERALS BLVD STE F
LINCOLNTON NC
28092-3537
US

V. Phone/Fax

Practice location:
  • Phone: 980-939-5339
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MICAH NAYLOR
Title or Position: OWNER
Credential: DMD
Phone: 980-939-5339