Robert McDonald, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901600616 Issued in MI

Practice address

23200 Red Arrow Hwy
Mattawan, MI 49071-7774

Phone

(269) 668-6715

NPI assigned

Sep 3, 2020

Last updated

Sep 3, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Strive Dental Health, PLLC

  dba Woods Lake Dental

  • Dental Clinic/Center
  • Kalamazoo, MI
  • NPI 1982332201
  NPD Authorized official

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1033723408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23200 RED ARROW HWY",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490717774",
            "telephone_number": "269-668-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23200 RED ARROW HWY",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490717774",
            "telephone_number": "269-668-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mattawan Chiropractic Clinic, P.C.
• Mattawan Family Dentistry
• Mattawan Family Eye Care PLC
• Mattawan Pharmacy
• Hailey Maynard
• Robin Medendorp
• Midwest Chiropractic and Rehab LLC
• Amanda Lee Miller
• Sheryl Ann Miller, LIMITED LICENSE PSYC
• Rebekah Johanna Moffit-Freer I

• Dentist in Mattawan, MI
• Providers in Mattawan, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.