Charles McKenzie, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7636 Issued in AZ

Practice address

40815 N Ironwood Drive
Ste A102
Queen Creek, AZ 85242

Phone

(480) 457-1977

NPI assigned

Aug 26, 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

Enrolled in AZ

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

Interoperability endpoints

• Direct secure messaging: cmckenzie251608@direct.valleywisehealth.org

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.

• Maricopa County Special Health Care District

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1073576740
  Medicare reassignment NPD
• Maricopa County Special Health Care District

  • Adult Mental Health Clinic/Center
  • Mesa, AZ
  • NPI 1003273855
  NPD
• Maricopa County Special Health Care District

  • Federally Qualified Health Center (FQHC)
  • Mesa, AZ
  • NPI 1306265145
  NPD

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1306093984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40815 N IRONWOOD DRIVE",
            "address_2": "STE A102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "85242",
            "telephone_number": "480-457-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40815 N IRONWOOD DRIVE",
            "address_2": "STE A102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "85242",
            "telephone_number": "480-457-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-26",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "7636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Weston McDermott, DC
• Avie Gail Socorro Dela Cerna McDonald, SLP-CCC
• Jason Derek McDonald, DC
• Jaylin McFarland, RBT
• Deborah Lynn McGarry, ACNP-BC
• Darrian Marisa McKiernan
• Mercadie McLaughlin, COTA/L
• Will A McLaws, P.A.
• Kelly Allison McMillan, PA-C
• Abby McNeil, OTR/L

• General Practice Dentistry in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.