Thomas Joseph Madl Jr., D.M.D

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30020664 Issued in OH

Practice address

1003 Harrison Ave
Suite 300
Harrison, OH 45030-1799

Phone

(513) 367-4048

Fax

(513) 367-4068

NPI assigned

Jan 2, 2007

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)

Not enrolled

State licenses

Practice roles

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.

• Thomas J Madl Jr DMD, LLC

  • Pediatric Dentistry
  • Harrison, OH
  • NPI 1922165943
  NPD (past) Authorized official
• Harrison Petr Vaughan, DDS, LLC

  • Pediatric Dentistry
  • Harrison, OH
  • NPI 1245033356
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1720145832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 HARRISON AVE",
            "address_2": "SUITE 300",
            "city": "HARRISON",
            "state": "OH",
            "postal_code": "450301799",
            "telephone_number": "513-367-4048",
            "fax_number": "513-367-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 HARRISON AVE",
            "address_2": "SUITE 300",
            "city": "HARRISON",
            "state": "OH",
            "postal_code": "450301799",
            "telephone_number": "513-367-4048",
            "fax_number": "513-367-4068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADL",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30020664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2038244",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desiree Long
• Kerrie Lovins, CDCA
• Rachel Lee Lunsford, LPN
• Molly Lysaght, RDN, LD
• Cortney Macdonald, HAS
• Amy Maliborski
• Samantha Malloni, LCDCIII
• Matthew Mason
• Masonbrooks Home Care
• Samantha Nicole May, RN

• Pediatric Dentistry in Harrison, OH
• Providers in Harrison, OH by specialty
• Pediatric Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.