Individual provider Active NPI

Kathryn Faye McDonough, D.M.D

  • Dentist
  • Pittsburgh, PA
National Provider Identifier
1417397241
Registry record updated Dec 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS039592 Issued in PA
Practice address
393 Vanadium Rd
Pittsburgh, PA 15243-1427
Phone
(412) 429-8900
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS039592 PA Primary

Addresses

Primary practice location

393 Vanadium Rd
Pittsburgh, PA 15243-1427

Mailing address

114 Timber Oak CT
Venetia, PA 15367-2312
Phone (412) 418-3378

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150622001911 PA Order and Referring Only - DentistPractitioner - Dentist 4183935851

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Primary Care Physicians, Inc. Past Accepting new patients
Lacy Medical Group Inc Past Accepting new patients

Organizations & group practices 2

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417824000000",
    "number": "1417397241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 TIMBER OAK CT",
            "city": "VENETIA",
            "state": "PA",
            "postal_code": "153672312",
            "telephone_number": "412-418-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 VANADIUM RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152431427",
            "telephone_number": "412-429-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "KATHRYN",
        "middle_name": "FAYE",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2014-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.