Kenneth McGowan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9844 Issued in OR

Practice address

1123 E Main St
Medford, OR 97504-7434

Phone

(541) 773-3422

Fax

(541) 779-2250

NPI assigned

Aug 19, 2011

Last updated

Sep 26, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• East Main Dental Center, LLP

  • General Practice Dentistry
  • Medford, OR
  • NPI 1700819596
  NPD (past)

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1457631608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047434",
            "telephone_number": "541-773-3422",
            "fax_number": "541-779-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047434",
            "telephone_number": "541-773-3422",
            "fax_number": "541-779-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-19",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5006546600",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Sharleen McGee, CRM, CADC-R
• Sherry McGee
• Theodore John McGill, MD
• Hanna Joellyn McGinnis
• Lilly Katherine McGonegal, PA
• Martha McGowen
• Kenneth McGrath, LMT
• Alexandria Anne McHugh, PHARMD
• Araceli Olivares McIff
• Samantha McIntyre, LMT

• General Practice Dentistry in Medford, OR
• Providers in Medford, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.

Verify at the official NPI Registry.