Richard Scott Mayo, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30018777 Issued in OH

Practice address

750 Boardman Poland Rd
Boardman, OH 44512-5137

Phone

(330) 726-7838

Fax

(330) 726-0766

NPI assigned

Aug 2, 2005

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1720089576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BOARDMAN POLAND RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125137",
            "telephone_number": "330-726-7838",
            "fax_number": "330-726-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BOARDMAN POLAND RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125137",
            "telephone_number": "330-726-7838",
            "fax_number": "330-726-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "RICHARD",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30018777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL OF OHIO",
            "identifier": "303057646",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maximo B. Lockward, M.D., LLC
• Desiree Lynn Maxon, PTA
• Penny J May, HIS
• Katerina Mayer, IMFT
• Cryscilla Maynard, PA-C
• Courtney Todd Mazey, MAC, PC
• Kimberly Lynn MC Abee, M.D.
• Amanda Mae McAllen, CNP
• Jonathon Richard McCann, MD
• Kimberly McCann

• Oral and Maxillofacial Surgery (Dentist) in Boardman, OH
• Providers in Boardman, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.