Active NPI
Sandra L. Macdonald, DMD
- General Practice Dentistry
- Plymouth, MA
National Provider Identifier
1679583116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 17726
- Practice address
- 110 Long Pond Road
#204
Plymouth, MA 02360 - Phone
- (508) 830-3339
- Fax
- (508) 830-1976
- NPI assigned
- Aug 8, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 17726 | MA | Primary |
Addresses
Primary practice location
110 Long Pond Road
#204
Plymouth, MA 02360
Mailing address
110 Long Pond Road
#204
Plymouth, MA 02360
Phone (508) 830-3339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 30, 2023 through Jan 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17726 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1679583116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 LONG POND ROAD",
"address_2": "#204",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "02360",
"telephone_number": "508-830-3339",
"fax_number": "508-830-1976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 LONG POND ROAD",
"address_2": "#204",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "02360",
"telephone_number": "508-830-3339",
"fax_number": "508-830-1976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDONALD",
"first_name": "SANDRA",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2023-09-12",
"certification_date": "2023-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "17726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.