Jay Dexter McKenzie, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901010244 Issued in MI

Practice address

20905 Greenfield Rd
Suite 400
Southfield, MI 48075-5360

Phone

(248) 569-2323

Fax

(248) 569-1150

NPI assigned

May 25, 2008

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1211673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211673600000",
    "number": "1215195409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD",
            "address_2": "SUITE 400",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755360",
            "telephone_number": "248-569-2323",
            "fax_number": "248-569-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD",
            "address_2": "SUITE 400",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755360",
            "telephone_number": "248-569-2323",
            "fax_number": "248-569-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "JAY",
        "middle_name": "DEXTER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-25",
        "last_updated": "2008-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901010244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashawndra Patrice McIntosh, L.P.N
• Tonia M McKay
• Tionna McKeller
• Alasdair I.L. McKendrick, M.D.
• Gary McKenzie, FNP-C
• Denise McKinney, PCA
• Elizabeth McKnight
• McLaren Community Based Primary Care Group
• McLaren Oakland
• Lauren Ann McLaughlin, TLLP

• General Practice Dentistry in Southfield, MI
• Providers in Southfield, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2008; 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.