Thomas John McDonald, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901014262 Issued in MI

Practice address

117 S Kinney Ave
Mt Pleasant, MI 48858-2702

Phone

(989) 732-1337

Fax

(989) 779-1094

NPI assigned

Oct 11, 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

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

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.

• Gladwin Dental Care, P.C.

  • General Practice Dentistry
  • Gladwin, MI
  • NPI 1699975862
  NPD (past)
• Mt Pleasant Family Dental Center PC

  • Dentist
  • Mt Pleasant, MI
  • NPI 1982714390
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1205924586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S KINNEY AVE",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582702",
            "telephone_number": "989-773-2133",
            "fax_number": "989-779-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S KINNEY AVE",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582702",
            "telephone_number": "989-732-1337",
            "fax_number": "989-779-1094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 S Bowery Ave",
            "address_purpose": "LOCATION",
            "city": "Gladwin",
            "state": "MI",
            "postal_code": "486242013",
            "country_code": "US",
            "telephone_number": "989-426-6581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901014262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Lane McConnon, M.D.
• Thomas McConnon, MD
• Anna Linee McCoy
• Amy Louise McDonald, MSPT
• Matthew John McDonald, LLMSW, MSW, BSW
• Adam McElyea
• Karen Michelle McGee, LMSW, CAAC
• Carrie Anne McGillis, ATC
• Chelsey Kaitlyn McGillis
• Greg McGillvary

• General Practice Dentistry in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.