ETHAN WILLIAM MCKINNEY
NPI 1174416457
Dentist - General Practice in Sioux Falls, SD
NPI Status: Active since June 03, 2025
Contact Information
5121 S SOLBERG AVE STE 120
SIOUX FALLS, SD
ZIP 57108
Phone: (605) 339-2955
- Individual
- Male
- Dentist
- General Practice
- Opted-Out Medicare
About ETHAN MCKINNEY
This page provides the complete NPI Profile along with additional information for Ethan Mckinney, a provider established in Sioux Falls, South Dakota with a medical specialization in Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1174416457 assigned on June 2025. The practitioner's primary taxonomy code is 1223G0001X with license number 1223G0001X (SD). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1174416457
- Provider Name
- ETHAN WILLIAM MCKINNEY
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 5121 S SOLBERG AVE STE 120 SIOUX FALLS, SD 57108
- Location Phone
- (605) 339-2955
- Mailing Address
- 5121 S SOLBERG AVE STE 120 SIOUX FALLS, SD 57108
- Mailing Phone
- (605) 339-2955
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-03-2025
- Last Update Date
- 06-03-2025
- Code Navigator
A dentist like Ethan Mckinney is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Ethan Mckinney opted out of Medicare effective on 09-11-2025 until 09-11-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist General Practice
- Taxonomy Code
- 1223G0001X
- Type
- Dental Providers
- License No.
- 1223G0001X
- License State
- SD
- Taxonomy Description
- 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.
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 09-11-2025
Opt-Out End Date: 09-11-2027
Eligible to Order and Refer? No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1174416457, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 53 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174416457, enumerated as an "individual" on June 03, 2025.
The provider is located at 5121 S SOLBERG AVE STE 120 SIOUX FALLS, SD 57108 and the phone number is (605) 339-2955.
Dentist with taxonomy code 1223G0001X and a focus in General Practice.
