Active NPI
Debra C McIntosh, DMD
- General Practice Dentistry
- Mason, OH
National Provider Identifier
1548365190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19715
- Practice address
- 3615 Socialville Foster Rd
Suite E
Mason, OH 45040-9671 - Phone
- (513) 573-9949
- Fax
- (513) 573-9367
- NPI assigned
- Sep 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19715 | OH | Primary |
Addresses
Primary practice location
3615 Socialville Foster Rd
Suite E
Mason, OH 45040-9671
Mailing address
3615 Socialville Foster Rd
Suite E
Mason, OH 45040-9671
Phone (513) 573-9949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19715 | Other | OH | LICENSE NUMBER |
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 |
|---|---|---|---|
| 19715 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548365190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3615 SOCIALVILLE FOSTER RD",
"address_2": "SUITE E",
"city": "MASON",
"state": "OH",
"postal_code": "450409671",
"telephone_number": "513-573-9949",
"fax_number": "513-573-9367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3615 SOCIALVILLE FOSTER RD",
"address_2": "SUITE E",
"city": "MASON",
"state": "OH",
"postal_code": "450409671",
"telephone_number": "513-573-9949",
"fax_number": "513-573-9367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTOSH",
"first_name": "DEBRA",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "19715",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "19715",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mason, OH
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.