Provider Demographics
NPI:1780648576
Name:MCGINNIS, MICHAEL A (DDS MS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:MCGINNIS
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 WILSON HALL RD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-1889
Mailing Address - Country:US
Mailing Address - Phone:803-905-4404
Mailing Address - Fax:803-905-4406
Practice Address - Street 1:1210 WILSON HALL RD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1889
Practice Address - Country:US
Practice Address - Phone:803-905-4404
Practice Address - Fax:803-905-4406
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3273122300000X
SC4741223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
872701OtherUNITED CONCORDIA
SCZ32732Medicaid
AL88003121OtherBLUE CROSS BLUE SHIELD
SCZ32732Medicaid