Organization Active NPI

Lynette M. McDonald DDS PA

  • Dentist
  • Fayetteville, NC
National Provider Identifier
1710984463
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5513 Issued in NC
Legal business name
LYNETTE M. MCDONALD DDS PA
Practice address
2537B Raeford Rd
Fayetteville, NC 28305-5161
Phone
(910) 433-4600
Fax
(910) 486-6995
NPI assigned
Jul 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Authorized official

Name
Ms. Lynette M McDonald, DDS
Title
Owner/Dentist
Phone
(910) 433-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5513 NC Primary

Addresses

Primary practice location

2537B Raeford Rd
Fayetteville, NC 28305-5161

Mailing address

2537B Raeford Rd
Fayetteville, NC 28305-5161
Phone (910) 433-4600

Other identifiers 2

IdentifierTypeStateIssuer
95581OtherBCBS
822123OtherUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

2537 Raeford Rd
Ste B
Fayetteville, NC 28305
Phone (910) 433-4600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1710984463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537B RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055161",
            "telephone_number": "910-433-4600",
            "fax_number": "910-486-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2537B RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055161",
            "telephone_number": "910-433-4600",
            "fax_number": "910-486-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNETTE M. MCDONALD DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "910-433-4600",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "5513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "95581",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "822123",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.