Individual provider Active NPI

Douglas Windsor McLoney Jr., D.M.D

  • Dentist
  • Morehead, KY
National Provider Identifier
1790875771
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5986 Issued in KY
Practice address
309 E Main St
Morehead, KY 40351-1659
Phone
(606) 784-6436
Fax
(606) 784-1665
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5986 KY Primary

Addresses

Primary practice location

309 E Main St
Morehead, KY 40351-1659

Mailing address

309 E Main St
Morehead, KY 40351-1659
Phone (606) 784-6436

Other identifiers 1

IdentifierTypeStateIssuer
60059862MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20160901002296 KY Order and Referring Only - DentistPractitioner - Dentist 1254627110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5986KYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Morehead Dental Group, PSC Past Accepting new patients
Angela S Frederick, DMD Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1790875771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E MAIN ST",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511659",
            "telephone_number": "606-784-6436",
            "fax_number": "606-784-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E MAIN ST",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511659",
            "telephone_number": "606-784-6436",
            "fax_number": "606-784-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLONEY",
        "first_name": "DOUGLAS",
        "middle_name": "WINDSOR",
        "name_suffix": "Jr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "5986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60059862",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead, KY

Sources for this page

Verify at the official NPI Registry.