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IVAN MCKINNEY DDS
NPI 1720207673
Dentist - General Practice in Tyler, TX

Active since April 25, 2007PECOS Enrolled
3802 BROOKSIDE DR, TYLER, TX 75701(903) 581-0581(903) 581-3978 Get Directions Write a Review

NPPES record last updated: June 12, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ivan Mckinney Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IVAN MCKINNEY DDS (NPI 1720207673) is an individual general practice provider in Tyler, Texas, licensed in Texas (10724) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720207673
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameIVAN MCKINNEYCredential: DDS
Location Address3802 BROOKSIDE DRTyler, TX 75701-9420
Mailing Address3802 Brookside DrTyler, TX 75701-9420 · (903) 581-0581 · Fax (903) 581-3978
Phone(903) 581-0581
Fax(903) 581-3978
Sole ProprietorYes
Enumeration DateApril 25, 2007
Last NPPES UpdateJune 12, 2008
✔ NPI 1720207673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in TX · 10724
Definition
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.
3802 BROOKSIDE DR, Tyler, TX 75701
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Other Identifiers 2

OtherD10724TX · Blue Cross Blue Shield
Other585455TX · United Concordia

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ivan Mckinney Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANDREW PHILLEY D.D.S.
Dentist (General Practice)
3802 BROOKSIDE DR
TYLER, TX 75701
Smith County (903) 581-0581

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ivan Mckinney's NPI number?

The NPI number for Ivan Mckinney is 1720207673. It was assigned to this individual provider in the NPPES registry on April 25, 2007.

Where is Ivan Mckinney located?

Ivan Mckinney practices at 3802 Brookside Dr, Tyler, TX 75701. The listed phone number is (903) 581-0581.

What is Ivan Mckinney's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Ivan Mckinney enrolled in Medicare?

Yes. Ivan Mckinney is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ivan Mckinney was last updated on June 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.