Keith E. McDonald, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE00010042 Issued in WA

Practice address

451 Duvall Ave NE
Suite 140
Renton, WA 98059-4675

Phone

(425) 228-5437

Fax

(425) 663-7990

NPI assigned

Mar 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• House, Lee, Mast, McDonald and Nelson, PC

  • Pediatric Dentistry
  • Renton, WA
  • NPI 1770826927
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023085305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 DUVALL AVE NE",
            "address_2": "SUITE 140",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594675",
            "telephone_number": "425-228-5437",
            "fax_number": "425-663-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 DUVALL AVE NE",
            "address_2": "SUITE 140",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594675",
            "telephone_number": "425-228-5437",
            "fax_number": "425-663-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "KEITH",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE00010042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5048921",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa McDarby, PT
• Kimberly J McDermott, MD
• Ashlynn Michelle McDonald
• Brendan Roarke McDonald, DNP, ARNP, PMHNP-BC
• Jo McDonald
• Molly Beth McDonald, L.M.P.
• Serena McDonald
• Kara McDonough, OTR/L
• Tianrong McDu
• Tori McFall, MD

• Pediatric Dentistry in Renton, WA
• Providers in Renton, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.