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Active NPI 1720207673 Individual Practitioner Male Practitioner

Dr. Ivan Mckinney , DDS

Dentist - General Practice • Tyler, TX

Professional Overview & Biography Verified Profile Summary

Dr. Ivan Mckinney, DDS is a registered healthcare professional specializing in Dentist - General Practice in Tyler, TX. Practice services are available at 3802 BROOKSIDE DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3802 Brookside Dr

Tyler, TX 757019420

Telephone 9035810581
Fax 9035813978

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Tyler, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
84 Specialists

Practicing in Tyler, TX (10570 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 10724

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID United Concordia
585455 (TX)
Commercial Insurance / Payer ID Blue Cross Blue Shield
D10724 (TX)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Andrew Philley , DDS

Dentist - General Practice

NPI 1629333687

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
✅
NPI Profile Active June 12, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location June 12, 2008

Registered at 3802 BROOKSIDE DR, TYLER, TX 757019420 (Tel: 9035810581)

📍
Updated Business Mailing Address June 12, 2008

Registered at 3802 BROOKSIDE DR, TYLER, TX 757019420 (Tel: 9035810581)

👤
Provider Name / Credentials Updated June 12, 2008

Recorded as IVAN MCKINNEY, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 12, 2008

Dentist (License #10724 in TX)

🟢
Initial NPI Registration & Enumeration April 25, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1720207673
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 25, 2007
Last Update: June 12, 2008
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

3802 Brookside Dr

Tyler, TX 757019420

Phone: 9035810581

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.