John James McDonald, DDS

Individual provider Active NPI General Practice Dentistry · Randolph a F B, TX

NPI 1023004405 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1023004405
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
17587 (TX)
Practice address
221 3Rd St W
Randolph a F B, TX 78150-4800
Phone
(210) 652-1846
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
17587TXMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17587 TX Yes

Addresses

Primary practice location

221 3Rd St W
Randolph a F B, TX 78150-4800

Mailing address

4227 Autumn Glade
San Antonio, TX 78247-2037
Phone (210) 490-5695

Other providers in Randolph a F B, TX

All providers in Randolph a F B, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.