Active NPI
Kurt D Mackie, DDS
- Dentist
- Boerne, TX
National Provider Identifier
1396848198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14092
- Practice address
- 1677 River Rd
103
Boerne, TX 78006-2446 - Phone
- (830) 331-7355
- NPI assigned
- Sep 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 14092 | TX | Primary |
Addresses
Primary practice location
1677 River Rd
103
Boerne, TX 78006-2446
Mailing address
1677 River Rd
Suite 103
Boerne, TX 78006-2446
Phone (830) 331-7355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14092 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KD Mackie DDS PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Boerne, TX
- NPI 1740645936
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450137600000",
"number": "1396848198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1677 RIVER RD",
"address_2": "SUITE 103",
"city": "BOERNE",
"state": "TX",
"postal_code": "780062446",
"telephone_number": "830-331-7355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1677 RIVER RD",
"address_2": "103",
"city": "BOERNE",
"state": "TX",
"postal_code": "780062446",
"telephone_number": "830-331-7355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKIE",
"first_name": "KURT",
"middle_name": "D",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2015-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "14092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boerne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.