Alex R McDonald, PHD, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

42068 Issued in CA

Practice address

3300 Webster St.,
810
Oakland, CA 94609-3117

Phone

(510) 832-4466

Fax

(510) 832-4566

NPI assigned

Apr 8, 2011

Last updated

Apr 8, 2011By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 21, 2013 through Feb 21, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Alex R. McDonald, PHD, DDS, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Oakland, CA
  • NPI 1659415743
  NPD (past) Authorized official

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1154611390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST STE 810",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093123",
            "telephone_number": "510-832-4466",
            "fax_number": "510-832-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST.,",
            "address_2": "810",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093117",
            "telephone_number": "510-832-4466",
            "fax_number": "510-832-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "ALEX",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD, DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-08",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "42068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1659415743",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Shawhan McDaniel, MD
• Keith McDaniel, M.D.
• Kelvin D McDaniel
• Stacy McDaniel
• Alden Joseph McDonald III, M.D.
• Catherine Anne McDonald, MD, MPH
• Jenae Ann McDonald
• Sara Jayne McDonald
• Shivaun McDonald, PA
• Logan McDonnell

• Oral and Maxillofacial Surgery (Dentist) in Oakland, CA
• Providers in Oakland, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.