Jack B McEwan, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30-022456 Issued in OH

Practice address

1650 Coshocton Ave
Suite D
Mount Vernon, OH 43050-1547

Phone

(740) 392-2000

Fax

(740) 392-2002

NPI assigned

Feb 26, 2007

Last updated

Dec 18, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oral & Maxillofacial Surgery Centers Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Heath, OH
  • NPI 1407028095
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1063548022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COSHOCTON AVE",
            "address_2": "SUITE D",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501547",
            "telephone_number": "740-392-2000",
            "fax_number": "740-392-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COSHOCTON AVE",
            "address_2": "SUITE D",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501547",
            "telephone_number": "740-392-2000",
            "fax_number": "740-392-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEWAN",
        "first_name": "JACK",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30-022456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia K. McCoy, PTA
• Porsha McCullough
• Brianna Kay McCumber
• Victoria McDowell
• Melissa McElroy
• Megan McGhee
• Kenneth Jeromy McGowan, RPH
• Shannon McGregor
• Tina McGuire
• Dawn E McKee, PHD, CCC-SLP

• Oral and Maxillofacial Surgery (Dentist) in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.