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IVAN MCKINNEY DDS NPI 1720207673


NPI Information

NPI: 1720207673
Provider Name: IVAN MCKINNEY, DDS
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

PECOS Registration: Yes

Address:
3802 BROOKSIDE DR
TYLER, TX
ZIP 75701
Phone: (903) 581-0581
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Ivan Mckinney, DDS is a general practice dentist in Tyler, TX. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. Ivan Mckinney, DDS NPI is 1720207673. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3802 BROOKSIDE DR
TYLER, TX
ZIP 75701-420
Phone: (903) 581-0581
Fax: (903) 581-3978

The NPI 1720207673 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 4/25/2007 and was last updated on 6/12/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice10724TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D10724OTHERTEXASBLUE CROSS BLUE SHIELD
2$$$$$$$$$OTHERTEXASHUMANA DENTAL
3$$$$$$$$$OTHERTEXASASSURANT EMPLOYEE BENEFITS
4$$$$$$$$$OTHERTEXASSUN LIFE AND HEALTH
5$$$$$$$$$OTHERTEXASMETLIFE
6$$$$$$$$$OTHERTEXASDELTA DENTAL
7$$$$$$$$$OTHERTEXASSTERLING LIFE INSURANCE
8$$$$$$$$$OTHERTEXASSAFEHEALTH LIFE INSURANCE
9$$$$$$$$$OTHERTEXASAFLAC
10$$$$$$$$$OTHERTEXASHEALTHFIRST TPA
11$$$$$$$$$OTHERTEXASHEALTHPAYERS USA
12$$$$$$$$$OTHERTEXASDENTAL NETWORK OF AMERICA
13$$$$$$$$$OTHERTEXASGUARDIAN
14$$$$$$$$$OTHERTEXASCIGNA DENTAL
15$$$$$$$$$OTHERTEXASTRICARE
16$$$$$$$$$OTHERTEXASBENEFIT PLANNERS
17$$$$$$$$$OTHERTEXASUMB
18585455OTHERTEXASUNITED CONCORDIA
19$$$$$$$$$OTHERTEXASUNITED HEALTHCARE DENTAL
20$$$$$$$$$OTHERTEXASWEB TPA
21$$$$$$$$$OTHERTEXASTML IEBP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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