Provider Demographics
NPI:1588393292
Name:MCKINLEY, CALEB E (DDS)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:E
Last Name:MCKINLEY
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 MARIE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:SD
Mailing Address - Zip Code:57032-8261
Mailing Address - Country:US
Mailing Address - Phone:605-222-8379
Mailing Address - Fax:
Practice Address - Street 1:3220 W 57TH ST STE 115
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-3146
Practice Address - Country:US
Practice Address - Phone:605-222-8379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD14031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice