Jennifer M. Koonce, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6485 Issued in OK

Practice address

3 E Macarthur St
Shawnee, OK 74804-2141

Phone

(405) 275-4581

Fax

(405) 214-4409

NPI assigned

Jun 12, 2013

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Shawnee Dental, PLLC

  • Dentist
  • Shawnee, OK
  • NPI 1528804218
  NPD Authorized official
• Scot Shadid DDS

  • Dental Clinic/Center
  • Shawnee, OK
  • NPI 1447441373
  NPD (past)

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1427496389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 E MACARTHUR ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042141",
            "telephone_number": "405-275-4581",
            "fax_number": "405-214-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E MACARTHUR ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748042141",
            "telephone_number": "405-275-4581",
            "fax_number": "405-214-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONCE",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Ryan Kliewer, O.D.
• Kiersten Klinger
• Lisa Anne Knight, PT
• Johna Marie Knopp, LPN
• Makayla Kolat
• Kayxandra Koonce
• Kelli Denise Koons, M.D.
• Gina Kraft, ATC
• Chris Kunze, R.N.
• Ronald Dean Lacen

• General Practice Dentistry in Shawnee, OK
• Providers in Shawnee, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.