Provider Demographics
NPI:1437225919
Name:MCGEHEE, JOHN WARREN JR (DMD, MS, CERTIFICATE)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WARREN
Last Name:MCGEHEE
Suffix:JR
Gender:M
Credentials:DMD, MS, CERTIFICATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-995 WAILELE RD APT 31
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3037
Mailing Address - Country:US
Mailing Address - Phone:502-558-8126
Mailing Address - Fax:
Practice Address - Street 1:21ST DENTAL CO
Practice Address - Street 2:BOX 63037
Practice Address - City:MCBH KANEOHE BAY
Practice Address - State:HI
Practice Address - Zip Code:96863-3037
Practice Address - Country:US
Practice Address - Phone:808-257-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3259-03122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist