Individual provider Active NPI

Marco Donadio

  • Endodontics
  • Plymouth, MA
National Provider Identifier
1437318565
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
22119 Issued in MA
Practice address
110 Long Pond Rd
Plymouth, MA 02360-2642
Phone
(508) 747-4441
Fax
(508) 746-3558
NPI assigned
Jun 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 22119 MA Primary

Addresses

Primary practice location

110 Long Pond Rd
Plymouth, MA 02360-2642

Mailing address

59 Standish St
Duxbury, MA 02332-5027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150817001613 MA Order and Referring Only - DentistPractitioner - Dentist 3375858517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22119MAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1437318565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 STANDISH ST",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023325027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LONG POND RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602642",
            "telephone_number": "508-747-4441",
            "fax_number": "508-746-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONADIO",
        "first_name": "MARCO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "22119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.