Individual provider Active NPI

Robert A McDavid, D.D.S.

  • General Practice Dentistry
  • Lancaster, OH
National Provider Identifier
1356654149
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-023247 Issued in OH
Practice address
611 N Broad St
Lancaster, OH 43130-2525
Phone
(740) 687-6105
Fax
(740) 687-0399
NPI assigned
Jul 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30-023247 OH Primary

Addresses

Primary practice location

611 N Broad St
Lancaster, OH 43130-2525

Mailing address

611 N Broad St
Lancaster, OH 43130-2525
Phone (740) 687-6105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20150522001388 OH Order and Referring Only - DentistPractitioner - Dentist 3577883016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-023247OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Bruce B. Baker DDS and Dr. Robert a McDavid DDS LLC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1356654149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N BROAD ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431302525",
            "telephone_number": "740-687-6105",
            "fax_number": "740-687-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N BROAD ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431302525",
            "telephone_number": "740-687-6105",
            "fax_number": "740-687-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDAVID",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-21",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-023247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.