Active NPI
Jon Ward McDonald, DDS
- Dentist
- Los Alamos, NM
National Provider Identifier
1497863666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD3104
- Practice address
- 2101 Trinity Dr
Suite P
Los Alamos, NM 87544-4102 - Phone
- (505) 622-2426
- Fax
- (505) 661-4135
- NPI assigned
- Aug 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5918336 | UT | |
| Dentist | 122300000X | DD3104 | NM | Primary |
Addresses
Primary practice location
2101 Trinity Dr
Suite P
Los Alamos, NM 87544-4102
Mailing address
185 Central Park Square
Los Alamos, NM 87544
Phone (505) 662-2426
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
| License | State | Type | Specialty |
|---|---|---|---|
| DD3104 | NM | MD | Dentist |
| 5918336 | UT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ortiz & Moss Dental Associates, P.C | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Los Alamos, NM
- NPI 1366538571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463443200000",
"number": "1497863666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "185 CENTRAL PARK SQUARE",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "87544",
"telephone_number": "505-662-2426",
"fax_number": "505-661-4135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 TRINITY DR",
"address_2": "SUITE P",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875444102",
"telephone_number": "505-622-2426",
"fax_number": "505-661-4135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "JON",
"middle_name": "WARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-28",
"last_updated": "2016-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "5918336",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD3104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Alamos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.