Active NPI
Kevin Thomas McGlynn, D.M.D.
- General Practice Dentistry
- Pensacola, FL
National Provider Identifier
1629088265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11719
- Practice address
- 312 Kenmore Rd
Pensacola Outpatient Clinic/Dental
Pensacola, FL 32503-7462 - Phone
- (850) 471-7615
- NPI assigned
- Aug 8, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11719 | MD | Primary |
Addresses
Primary practice location
312 Kenmore Rd
Pensacola Outpatient Clinic/Dental
Pensacola, FL 32503-7462
Mailing address
1176 Old TRL
Gulf Breeze, FL 32563-5536
Phone (850) 932-2709
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 |
|---|---|---|---|
| 11719 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1629088265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1176 OLD TRL",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325635536",
"telephone_number": "850-932-2709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 KENMORE RD",
"address_2": "PENSACOLA OUTPATIENT CLINIC/DENTAL",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325037462",
"telephone_number": "850-471-7615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGLYNN",
"first_name": "KEVIN",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "11719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.