Amanda R Donnelly, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21342 Issued in OH

Practice address

742 Graham Rd
Cuyahoga Falls, OH 44221-1055

Phone

(330) 929-2616

Fax

(330) 929-2636

NPI assigned

Oct 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639263825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 MEADOW LN",
            "city": "PENINSULA",
            "state": "OH",
            "postal_code": "442649792",
            "telephone_number": "330-928-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 GRAHAM RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442211055",
            "telephone_number": "330-929-2616",
            "fax_number": "330-929-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "AMANDA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "21342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "01496920",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DK Family Health Center
• Alexa Dodson
• Jennifer Domino, CNP
• Don E Secrest DDS Inc
• Arielle Donkers, RPH
• Kiran R Donthi, MD
• Elle Kathryn Dorflinger, LISW
• Kelley Doss, RPH
• Melissa B. Dougherty, COTA/L
• John Dowler

• General Practice Dentistry in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• General Practice Dentistry in Ohio

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.