PHILLIP M. MCKEAN PROFESSIONAL CORPORATION (NPI# 1699324103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699324103 |
| Entity Type | Organization |
| Organization Name | PHILLIP M. MCKEAN PROFESSIONAL CORPORATION |
| Practice Address |
6605 E State Blvd Ste 7 Fort Wayne IN 46815-7036 |
| Practice Telephone | 2604862339 |
| Practice Fax Number | 2604863219 |
| Mailing Telephone | 2604862339 |
| Mailing Fax Number | 2604863219 |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2019-09-06 |
| Authorized Official Name | VICKEY RAY HULLINGER (OFFICE MANAGER) |
| Authorized Official Telephone | 2604862339 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300028091 | 05 |
| Street Address |
6605 E STATE BLVD STE 7 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815-7036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1962823138 | Chad Distelrath | Physical Therapy Assistant | 1717 Maplecrest Rd, Apt 112, Fort Wayne, IN 46815 | 2013-12-13 |
| 1689943409 | Kendall Joan Labrash | Physical Therapist | 4251 Lahmeyer Rd., Fort Wayne, IN 46815 | 2011-12-22 |
| 1801179718 | Jayson Laube | Pharmacist | 6201 Stellhorn, Fort Wayne, IN 46815 | 2011-09-27 |
| 1720294432 | Muscle Therapy Clinic LLC | Massage Therapist | 6409 Georgetown North Blvd, Fort Wayne, IN 46815 | 2007-05-16 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1932252772 | Fort Wayne Smiles PC | Dentist | 2031 Reed Road, Fort Wayne, IN 46815 | 2007-01-18 |
| 1811078538 | Timothy Doody Lynch | Dentist | 4207 Hobson Court, Fort Wayne, IN 46815 | 2006-10-18 |
| Find all providers in zip 46815 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679186258 | James Patrick Thompson | Dentist | 5909 Wheelock Rd Ste 102, Fort Wayne, IN 46835-9258 | 2020-08-25 |
| 1295357481 | Sycamore Hills Dentistry | Dentist | 10082 Illinois Rd, Fort Wayne, IN 46804-5772 | 2020-05-11 |
| 1598322083 | Charles Chase Ellinwood | Dentist | 5725 Maplecrest Rd Ste 1, Fort Wayne, IN 46835-4937 | 2019-05-21 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1821582172 | Jacob Yager | Dentist | 9830 Auburn Rd Ste 101, Fort Wayne, IN 46825-2464 | 2018-06-20 |
| 1740772656 | Colleen Rose Allen | Dentist | 10213 Dupont Circle Dr W, Fort Wayne, IN 46825-1656 | 2018-06-06 |
| 1407360910 | Grace Xinxing Clark | Dentist | 4716 Illinois Rd Ste 101, Fort Wayne, IN 46804-5123 | 2017-11-20 |
| 1578959375 | Ronald L Rumbaugh Dds PC | Dentist | 10506 Coldwater Rd, Fort Wayne, IN 46845-1235 | 2015-04-09 |
| 1619388063 | Familia Dental Spfw Pllc | Dentist | 100 E Pettit Ave, 1a, Fort Wayne, IN 46806-3003 | 2014-05-19 |
| 1467792663 | Familia Dental Fort Wayne Pllc | Dentist | 5328 Coldwater Rd, Fort Wayne, IN 46825-5445 | 2013-02-25 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
Please comment or provide details below to improve the information on PHILLIP M. MCKEAN PROFESSIONAL CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.