John P McKim DMD PC

Primary specialty

DentistTaxonomy code 122300000X

License

4584 Issued in OR

Legal business name

JOHN P MCKIM DMD PC

Practice address

1110 Fairfield Ave
Eugene, OR 97402

Phone

(541) 689-1645

NPI assigned

May 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Palmer McKim, DMD

Title

Pres

Phone

(541) 689-1645

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174730253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 FAIRFIELD AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97402",
            "telephone_number": "541-689-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 FAIRFIELD AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97402",
            "telephone_number": "541-689-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN P MCKIM DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKIM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PALMER",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "541-689-1645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "4584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Eugene, OR
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.