Individual provider Active NPI

Donnie Elwood Mayhew, D.D.S.

  • Periodontics
  • Roanoke, VA
National Provider Identifier
1447569959
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
0401005515 Issued in VA
Practice address
1930 Electric Rd
Roanoke, VA 24018-1621
Phone
(540) 989-1170
NPI assigned
Sep 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 0401005515 VA Primary

Addresses

Primary practice location

1930 Electric Rd
Roanoke, VA 24018-1621

Mailing address

1930 Electric Rd
Roanoke, VA 24018-1621
Phone (540) 989-1170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401005515VAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Coots Ward Cross Dentistry Past Accepting new patients
CLQ&P Dentistry PLLC PastSince Jan 22, 2023 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": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1447569959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181621",
            "telephone_number": "540-989-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181621",
            "telephone_number": "540-989-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYHEW",
        "first_name": "DONNIE",
        "middle_name": "ELWOOD",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401005515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.