Active NPI
Kesa J. McConnell, DDS
- General Practice Dentistry
- Okc, OK
National Provider Identifier
1427086867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5877
- Practice address
- 3727 NW 63Rd, Ste 107
Okc, OK 73116 - Phone
- (405) 810-8995
- Fax
- (405) 810-8984
- NPI assigned
- Jun 28, 2006
- Last updated
- Feb 28, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 5877 | OK | Primary |
Addresses
Primary practice location
3727 NW 63Rd, Ste 107
Okc, OK 73116
Mailing address
3727 NW 63Rd, Ste 107
Okc, OK 73116
Phone (405) 810-8995
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 |
|---|---|---|---|
| 5877 | OK | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkway Dental Group PLLC | Past | Accepting new patients | |
| Amy Croom Kuker, DDS | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Oklahoma City, OK
- NPI 1689050452
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551312000000",
"number": "1427086867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3727 NW 63RD, STE 107",
"city": "OKC",
"state": "OK",
"postal_code": "73116",
"telephone_number": "405-810-8995",
"fax_number": "405-810-8984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3727 NW 63RD, STE 107",
"city": "OKC",
"state": "OK",
"postal_code": "73116",
"telephone_number": "405-810-8995",
"fax_number": "405-810-8984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "KESA",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2019-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "5877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Okc, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.