Provider Demographics
NPI:1912771429
Name:MCMENAMIN, SUMMER H (RDH)
Entity type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:H
Last Name:MCMENAMIN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SHORT DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-2818
Mailing Address - Country:US
Mailing Address - Phone:302-379-1166
Mailing Address - Fax:
Practice Address - Street 1:4 SHORT DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-2818
Practice Address - Country:US
Practice Address - Phone:302-379-1166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH071992124Q00000X
DEG2-0002859124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist