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Contact Information

JOHN D GAGNON, DDS
3510 N RIDGE RD
STE 500
WICHITA, KS67205-1224
 Phone: 316-722-0800
 Fax: 316-722-5822
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for JOHN D GAGNON · (Male)

NPI # 1619911641
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 06/16/2006
Last updated 11/12/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • KS License # 6850
  • KS Medicaid 100317420A
  • Other 974027 UNITED CONCORDIA
  • KS Other 116677 BCBS OF KS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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