Active NPI
Michael Brian McMahon, D.D.S.
- Periodontics
- Bakersfield, CA
National Provider Identifier
1306194303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 31065
- Practice address
- 1314 L St
Bakersfield, CA 93301-4509 - Phone
- (661) 325-5796
- Fax
- (661) 325-5142
- NPI assigned
- Aug 22, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 31065 | CA | Primary |
Addresses
Primary practice location
1314 L St
Bakersfield, CA 93301-4509
Mailing address
1314 L St
Bakersfield, CA 93301-4509
Phone (661) 325-5796
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150714001032 | CA | Order and Referring Only - Oral Surgery | 7416260898 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31065 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345593600000",
"number": "1306194303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1314 L ST",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933014509",
"telephone_number": "661-325-5796",
"fax_number": "661-325-5142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1314 L ST",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933014509",
"telephone_number": "661-325-5796",
"fax_number": "661-325-5142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHON",
"first_name": "MICHAEL",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-22",
"last_updated": "2012-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "31065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2012; 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.