Keavin G McIntosh, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00008897 Issued in WA

Practice address

2511 Meridian Ave E
Edgewood, WA 98371

Phone

(253) 845-8817

Fax

(253) 845-6491

NPI assigned

Aug 11, 2006

Last updated

Sep 1, 2023By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• North Hill Dental

  • Dental Clinic/Center
  • Edgewood, WA
  • NPI 1598623142
  NPD

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1194736363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 MERIDIAN AVE E",
            "city": "EDGEWOOD",
            "state": "WA",
            "postal_code": "98371",
            "telephone_number": "253-845-8817",
            "fax_number": "253-845-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 MERIDIAN AVE E",
            "city": "EDGEWOOD",
            "state": "WA",
            "postal_code": "98371",
            "telephone_number": "253-845-8817",
            "fax_number": "253-845-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "KEAVIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5039441",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl E Luther, D.O.
• Sheri Martin
• Ami Mason, RN
• Catherine Kendall Matthews
• Mitchell Grant Maughan, DDS
• Maureen Lee Miller
• Lorraine Renee Mitchell, OTR/L
• NB Exim LLC
• Pamela Jean Nordeen, LMP
• North Hill Chiropractic PLLC

• General Practice Dentistry in Edgewood, WA
• Providers in Edgewood, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.