Individual provider Active NPI

Kacie L McKeon, DMD

  • General Practice Dentistry
  • Helena, MT
National Provider Identifier
1376324582
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN-DEN-LIC-26121 Issued in MT
Practice address
630 N Last Chance Gulch Ste 1100
Helena, MT 59601-3551
Phone
(406) 457-0000
NPI assigned
Oct 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN-DEN-LIC-26121 MT Primary

Addresses

Primary practice location

630 N Last Chance Gulch Ste 1100
Helena, MT 59601-3551

Mailing address

280 Grizz Ave # 280-a
Helena, MT 59602-7176
Phone (406) 560-7723

Other practice location 1

445 Centennial Ave
Butte, MT 59701-2870
Phone (406) 496-6007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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

Enrollment IDStateProvider typePAC IDDetails
I20250318001072 MT Order and Referring Only - DentistPractitioner - Dentist 3779005913

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN-DEN-LIC-26121MTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1376324582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 GRIZZ AVE # 280-A",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596027176",
            "telephone_number": "406-560-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N LAST CHANCE GULCH STE 1100",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596013551",
            "telephone_number": "406-457-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "445 Centennial Ave",
            "address_purpose": "LOCATION",
            "city": "Butte",
            "state": "MT",
            "postal_code": "597012870",
            "country_code": "US",
            "telephone_number": "406-496-6007",
            "fax_number": "406-496-6035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKEON",
        "first_name": "KACIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-12",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "DEN-DEN-LIC-26121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

Sources for this page

Verify at the official NPI Registry.