Mark Kenneth McDaniels, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00006052 Issued in WA

Practice address

350 S 38TH CT Ste 225
Renton, WA 98055-5775

Phone

(425) 271-1515

Fax

(425) 228-4146

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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 and National Provider Directory roles.

• Dr. Mark McDaniels

  • Exclusive Provider Organization
  • Renton, WA
  • NPI 1386199867
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1154493724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S 38TH CT STE 225",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555775",
            "telephone_number": "425-271-1515",
            "fax_number": "425-228-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S 38TH CT STE 225",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555775",
            "telephone_number": "425-271-1515",
            "fax_number": "425-228-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIELS",
        "first_name": "MARK",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K439D7",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE DEPT OF HEALTH",
            "identifier": "DE00006052",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret D. McCulloch, MSW
• Jessica Anne McCullough, LMP
• Lashanda McCurdy, L.M.T.
• Danielle Ann McCurley
• Kathryn McCurnin, LMSW
• Melissa McDarby, PT
• Kimberly J McDermott, MD
• Ashlynn Michelle McDonald
• Brendan Roarke McDonald, DNP, ARNP, PMHNP-BC
• Jo McDonald

• General Practice Dentistry in Renton, WA
• Providers in Renton, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.