John Robert Magnacca, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

06221 Issued in FL

Practice address

900 NW 13TH St
Suite 202
Boca Raton, FL 33486-2335

Phone

(561) 391-6234

Fax

(561) 391-0743

NPI assigned

Jan 16, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417009150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 NW 13TH STREET",
            "address_2": "SUITE 202",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33486",
            "telephone_number": "561-391-6234",
            "fax_number": "561-391-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NW 13TH ST",
            "address_2": "SUITE 202",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862335",
            "telephone_number": "561-391-6234",
            "fax_number": "561-391-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNACCA",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "06221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ravinder S Mahal, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.