Gagnon, John D

Gagnon, John D is an individual health care provider with primary practice located at 3510 N Ridge Rd Ste 500, Wichita KS 67205-1224. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Gagnon, John D can be contacted via phone (316) 722-0800.

Contact Information

Primary practice address
3510 N Ridge Rd Ste 500 Wichita KS 67205-1224
Phone: (316) 722-0800
Fax: (316) 722-5822
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 6850 Kansas
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 6850 Kansas

Profile Details

NPI number 1619911641
LBN Legal business name Gagnon, John D
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Nov 12th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619911641 NPPES
Kansas Other 116677 BCBS OF KS
Kansas Other 974027 BCBS OF KS
Kansas MEDICAID 100317420A BCBS OF KS

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