Active NPI
Marquish McKinnon
- Dental Assistant
- Gonzales, TX
National Provider Identifier
1083931380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 3227
- Practice address
- 228 Saint George St
Gonzales, TX 78629-3910 - Phone
- (830) 672-6511
- Fax
- (830) 672-6430
- NPI assigned
- Apr 26, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 3227 | TX | Primary |
Addresses
Primary practice location
228 Saint George St
Gonzales, TX 78629-3910
Mailing address
228 Saint George St
Gonzales, TX 78629-3910
Phone (830) 672-6511
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 |
|---|---|---|---|
| 3227 | TX | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272240000000",
"number": "1083931380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "228 SAINT GEORGE ST",
"city": "GONZALES",
"state": "TX",
"postal_code": "786293910",
"telephone_number": "830-672-6511",
"fax_number": "830-672-6430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "228 SAINT GEORGE ST",
"city": "GONZALES",
"state": "TX",
"postal_code": "786293910",
"telephone_number": "830-672-6511",
"fax_number": "830-672-6430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINNON",
"first_name": "MARQUISH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-26",
"last_updated": "2010-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "TX",
"license": "3227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gonzales, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.