MR. KENNETH EUGENE KOENKE (NPI# 1801955364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801955364 |
| Entity Type | Individual |
| Full Name | MR. KENNETH EUGENE KOENKE |
| Other Name | DR. KENNETH EUGENE KOENKE |
| Credential | DDS |
| Practice Address |
37 Bow St Freeport ME 04032 |
| Mailing Address |
13063 Brookmead Dr Manassas VA 20112 |
| Practice Telephone | 2078650673 |
| Mailing Telephone | 7037949219 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
12625 | MO | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
3792 | ME | Dental Providers |
| Street Address |
37 BOW ST |
| City | FREEPORT |
| State | ME |
| Zip Code | 04032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801355920 | Joyce Mary Nadeau | Psychologist | 4 Picnic Hill Rd, Freeport, ME 04032 | 2019-03-18 |
| 1689157729 | Tim Spaulding | Occupational Therapist | Hawthorne House, 6 Old County Rd, Freeport, ME 04032 | 2018-09-14 |
| 1538698212 | Travis Jeffery Bouchard | Surgery | 601 E. Hampden Ave., #220, Englewood, CA 04032 | 2017-06-07 |
| 1649522608 | Heather Danielle Parlin | Counselor | 19 Hunter Rd, Freeport, ME 04032 | 2012-10-15 |
| 1609137843 | Access Health Renewal | Clinic/Center | 174 So. Freeport Road, Suite 2a, Freeport, ME 04032 | 2012-06-05 |
| 1942571427 | Meghan Kathleen Gorchoff | Counselor | 13 Foggs Pt. Rd., Freeport, ME 04032 | 2012-01-16 |
| 1043435928 | Meredith Wall | Physician Assistant | 7 Campus Drive, Intermed Onsite At Llbean, Freeport, ME 04032 | 2007-04-16 |
| 1437212990 | Phoebe Snovek Prosky | Social Worker | 143 Flying Point Rd, Freeport, ME 04032 | 2006-12-18 |
| 1497851885 | Kathleen Ellen Sullivan | Social Worker | 16 Lincoln St., Suite C, Brunswick, ME 04032 | 2006-09-15 |
| 1104872639 | Shaws Supermarkets Inc | Durable Medical Equipment & Medical Supplies | 200 Lower Main St, Freeport, ME 04032 | 2006-05-26 |
| Find all providers in zip 04032 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891165643 | Freeport Dental | Dentist | 1450 S West Ave, Freeport, IL 61032-6351 | 2015-10-05 |
| 1417247529 | Lindsay L Shirley | Dentist | 30 Blueberry Road, Freeport, FL 32439 | 2011-04-10 |
| 1588962971 | Long Island Family Dentistry | Dentist | 26 W Merrick Rd, Freeport, NY 11520-3827 | 2011-03-08 |
| 1447486501 | Gary Alan Besley | Dentist | 1450 S. West Ave., Freeport, IL 61032 | 2009-06-03 |
| 1801060876 | Jose' Antonio Lazo | Dentist | 186 Atlantic Ave, Freeport, NY 11520-4923 | 2008-04-21 |
| 1447422456 | Freeport Dental, PC | Dentist | 117 W Sunrise Hwy, Freeport, NY 11520-3614 | 2008-03-31 |
| 1902081185 | Lorraine Ann Herrmann | Dentist | 268 W Merrick Rd, Freeport, NY 11520-3347 | 2008-01-07 |
| 1558573329 | Crispin Zapanta Ayroso | Dentist | 131 S Ocean Ave, Suite 5 & 6, Freeport, NY 11520-4548 | 2007-05-04 |
| 1730307240 | Jonathan Goold Strout | Dentist | 46 Mallett Dr, Freeport, ME 04032-1313 | 2007-04-22 |
| 1740305614 | Joseph H Wetherhold | Dentist | 348 Us Route 1, Freeport, ME 04032-7016 | 2007-03-20 |
| Find all providers in FREEPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.