Jason Raymond McDaniels, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

12123 Issued in NC

Practice address

2850 Lyndhurst Ave
Winston Salem, NC 27103-4110

Phone

(336) 768-1740

NPI assigned

May 22, 2007

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 IN

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

Locations

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.

• Jason R. McDaniels, D.D.S., PLLC

  dba Winston Endo

  • Dental Clinic/Center
  • Winston Salem, NC
  • NPI 1386215242
  NPD Authorized official
• Still Waters Family Dentistry, PC

  • Dentist
  • Ossian, IN
  • NPI 1326511189
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1285844225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 LYNDHURST AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034110",
            "telephone_number": "336-768-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 LYNDHURST AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034110",
            "telephone_number": "336-768-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIELS",
        "first_name": "JASON",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "12123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phyllis Lamarr McCutchen, CRNA
• Thomas McConnell McCutchen, MD
• Courtney Shaw McDaniel, MSN, NNP-BC
• Ikeyma McDaniel
• Kendalyn Faith McDaniel, MD
• Alison Eileen McDonald, MD
• Brittany McDonald
• Christin Stipp McDonald
• Colin Timothy McDonald, M.D.
• Michael James McDonald, CO

• Endodontics in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Endodontics in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.