Michael E McKenzie Jr, DDS LLC

Primary specialty

DentistTaxonomy code 122300000X

License

2015017896 Issued in MO

Legal business name

MICHAEL E MCKENZIE JR, DDS LLC

Practice address

2903 Saint Marys Ave
Hannibal, MO 63401-3714

Phone

(573) 822-3107

NPI assigned

Mar 7, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Michael E McKenzie Jr., DDSNPI 1598147795

Title

Dentist

Phone

(573) 822-3107

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael McKenzie, DDS

  • General Practice Dentistry
  • Hannibal, MO
  • NPI 1598147795
  NPD (past) Authorized official
• William Joseph Esicar, D.M.D

  • Dentist
  • Hannibal, MO
  • NPI 1720237399
  NPD (past)

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1467812297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 SAINT MARYS AVE",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634013714",
            "telephone_number": "573-221-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2903 SAINT MARYS AVE",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634013714",
            "telephone_number": "573-822-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E MCKENZIE JR, DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "573-822-3107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "2015017896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• E Sean Meyer, MA, LCSW
• Janis Meyers
• Jessica Nichole Mickels, RNFA
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• Bassem Mikhail, MD
• Paige Nicole Miles, PHARM. D
• Joshua Miley, ATC

• Dentist in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; 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.