Provider Demographics
NPI:1932373180
Name:MCKONE, JAMES NEHL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:NEHL
Last Name:MCKONE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BUSHAWAY RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-1945
Mailing Address - Country:US
Mailing Address - Phone:952-475-0225
Mailing Address - Fax:952-475-0776
Practice Address - Street 1:109 BUSHAWAY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-1945
Practice Address - Country:US
Practice Address - Phone:952-475-0225
Practice Address - Fax:952-475-0776
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND81461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice