Active NPI
McKenzie Swan, DDS
- General Practice Dentistry
- Shawnee, KS
National Provider Identifier
1336700228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 61656
- Practice address
- 21620 Midland Dr
Shawnee, KS 66218-9064 - Phone
- (913) 439-4269
- NPI assigned
- Jun 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 61656 | KS | Primary |
Addresses
Primary practice location
21620 Midland Dr
Shawnee, KS 66218-9064
Mailing address
3132 Southwest Trfy
Kansas City, MO 64111-2710
Phone (417) 209-0619
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240514003700 | KS | Order and Referring Only - Dentist | 5395186928 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561161600000",
"number": "1336700228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3132 SOUTHWEST TRFY",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641112710",
"telephone_number": "417-209-0619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21620 MIDLAND DR",
"city": "SHAWNEE",
"state": "KS",
"postal_code": "662189064",
"telephone_number": "913-439-4269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWAN",
"first_name": "MCKENZIE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-22",
"last_updated": "2019-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KS",
"license": "61656",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawnee, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2019; 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.