Douglas McKendry, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

3944 Issued in CA

Practice address

US Highway 160, S of MP 394.3
Kayenta, AZ 86033

Phone

(928) 697-4178

NPI assigned

Mar 19, 2015

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 TX

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

Locations

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

• DHHS IHS Phoenix Area

  • Clinic/Center
  • Peach Springs, AZ
  • NPI 1265719934

  TX

  Medicare reassignment NPD
• DHHS IHS Phoenix Area

  • Federal Public Health Clinic/Center
  • Havasu Lake, CA
  • NPI 1396022026

  TX

  Medicare reassignment NPD
• Irene Benn Medical Center

  • Clinic/Center
  • Moapa, NV
  • NPI 1841535317

  TX

  Medicare reassignment NPD
• DHHS IHS Phoenix

  • Clinic/Center
  • Supai, AZ
  • NPI 1184901829
  NPD
• DHHS IHS Phoenix Area

  • Critical Access Hospital
  • Parker, AZ
  • NPI 1851678585
  NPD

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1285028092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12033 AGENCY RD",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853447718",
            "telephone_number": "928-697-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HIGHWAY 160, S OF MP 394.3",
            "city": "KAYENTA",
            "state": "AZ",
            "postal_code": "86033",
            "telephone_number": "928-697-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENDRY",
        "first_name": "DOUGLAS",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-19",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "3944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Lemmon, MD
• Hilda Y Littleben, HT
• Martha Littleman
• Jacqueline Maynard, RN
• Nicolette McDermott-Ketchum, PAC
• Steven Metz
• Brian Jason Miller, RN
• Scott David Mitchell, PT, DPT
• Julia Monroe, RN
• Miles Soichi Morimoto, PHARMD

• Dentist in Kayenta, AZ
• Providers in Kayenta, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.