NPIMap

Individual provider Active NPI

Jonathan Scott Mandras, D.D.S.

  • General Practice Dentistry
  • Owings Mills, MD
National Provider Identifier
1609042522
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14317 Issued in MD
Practice address
20 Crossroads Dr
Suite 110
Owings Mills, MD 21117-5419
Phone
(410) 363-2500
Fax
(410) 363-0006
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14317 MD Primary

Addresses

Primary practice location

20 Crossroads Dr
Suite 110
Owings Mills, MD 21117-5419

Mailing address

20 Crossroads Dr
Suite 110
Owings Mills, MD 21117-5419
Phone (410) 363-2500

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
14317MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetime Dental Care of Maryland, Badger, P.C. Past Accepting new patients
MC Donogh Dental Associates LLP 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": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1609042522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CROSSROADS DR",
            "address_2": "SUITE 110",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175419",
            "telephone_number": "410-363-2500",
            "fax_number": "410-363-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CROSSROADS DR",
            "address_2": "SUITE 110",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175419",
            "telephone_number": "410-363-2500",
            "fax_number": "410-363-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDRAS",
        "first_name": "JONATHAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "14317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.