John David Mahilo, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.015776 Issued in OH

Practice address

102 N Hamilton Rd
Gahanna, OH 43230-2602

Phone

(614) 475-4544

Fax

(614) 475-0395

NPI assigned

Sep 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417059049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N HAMILTON RD",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432302602",
            "telephone_number": "614-475-4544",
            "fax_number": "614-475-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N HAMILTON RD",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432302602",
            "telephone_number": "614-475-4544",
            "fax_number": "614-475-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHILO",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.015776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0482473",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sarah Maguire, RDN, CSO, LD
• Tamara Mahmoud, DO
• James R Male III, DDS
• Rachel C Mancini-Grimm, O.D.
• April Lynn Mancuso, PSYD
• Charles J Manfresca, DO

• General Practice Dentistry in Gahanna, OH
• Providers in Gahanna, OH by specialty
• General Practice Dentistry in Ohio

• 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.
• 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.