Provider Demographics
NPI:1861594244
Name:MCANENY, NEIL G (DDS)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:G
Last Name:MCANENY
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 1:400 NEW LONDON RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-7010
Mailing Address - Country:US
Mailing Address - Phone:302-731-4907
Mailing Address - Fax:
Practice Address - Street 1:625 BARKSDALE RD.
Practice Address - Street 2:SUITE 117
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711
Practice Address - Country:US
Practice Address - Phone:302-731-4907
Practice Address - Fax:302-731-4932
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE809122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000909008Medicaid