Active NPI
James Nathan McKenna, DDS
- Dentist
- Phoenix, AZ
National Provider Identifier
1003336215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D009935
- Practice address
- 230 S 12TH Ave
Phoenix, AZ 85007-3101 - Phone
- (602) 362-0744
- NPI assigned
- Jun 20, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | D009935 | AZ | Primary |
Addresses
Primary practice location
230 S 12TH Ave
Phoenix, AZ 85007-3101
Mailing address
1145 10TH Ave E Unit 318
Seattle, WA 98102-4086
Phone (509) 710-8180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D009935 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James N McKenna DDS. | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523232000000",
"number": "1003336215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1145 10TH AVE E UNIT 318",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981024086",
"telephone_number": "509-710-8180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 S 12TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850073101",
"telephone_number": "602-362-0744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENNA",
"first_name": "JAMES",
"middle_name": "NATHAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-20",
"last_updated": "2018-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D009935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.