Provider Demographics
NPI:1952456220
Name:BURWINKEL-MCKENZIE, ANN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:BURWINKEL-MCKENZIE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:BURWINKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-0190
Mailing Address - Country:US
Mailing Address - Phone:937-393-1634
Mailing Address - Fax:937-393-8509
Practice Address - Street 1:323 N HIGH ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-1173
Practice Address - Country:US
Practice Address - Phone:937-393-1634
Practice Address - Fax:937-393-8509
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300-20085122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0984163Medicaid