Provider Demographics
NPI:1144115718
Name:MCNISH, LINCOLN LERON (DDS)
Entity type:Individual
Prefix:
First Name:LINCOLN
Middle Name:LERON
Last Name:MCNISH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 BOILER HOUSE RD BLDG 361
Mailing Address - Street 2:
Mailing Address - City:PERRY POINT
Mailing Address - State:MD
Mailing Address - Zip Code:21902-1103
Mailing Address - Country:US
Mailing Address - Phone:954-687-5111
Mailing Address - Fax:
Practice Address - Street 1:361 BOILER HOUSE RD BLDG 361
Practice Address - Street 2:
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21902-1103
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program