NPIMap

Organization Active NPI

McDonnell and McMahon Pediatric Dentistry PLLC

Doing business as The Smile Lodge

  • Pediatric Dentistry
  • Clifton Park, NY
National Provider Identifier
1821486754
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
48803 Issued in NY
Legal business name
MCDONNELL AND MCMAHON PEDIATRIC DENTISTRY PLLC
Doing business as
The Smile Lodge
Practice address
713 Pierce Rd
Clifton Park, NY 12065-1302
Phone
(518) 373-1181
Fax
(518) 373-0130
NPI assigned
Dec 30, 2014
Last updated
Jan 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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

Authorized official

Name
Dr. James P McDonnell, DMDNPI 1427039312
Title
Member
Phone
(518) 373-1181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 48803 NY Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 053734 NY
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 054764 NY
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 054477 NY
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 056708 NY
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 057555 NY
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 057644 NY

Addresses

Primary practice location

713 Pierce Rd
Clifton Park, NY 12065-1302

Mailing address

713 Pierce Rd
Clifton Park, NY 12065-1302
Phone (518) 373-1181

Other names 1

  • The Smile Lodge Doing business as

National Provider Directory

National Provider Directory

Locations

713 Pierce Rd
Clifton Park, NY 12065
Phone (518) 373-1181

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420156800000",
    "number": "1821486754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 PIERCE RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120651302",
            "telephone_number": "518-373-1181",
            "fax_number": "518-373-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 PIERCE RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120651302",
            "telephone_number": "518-373-1181",
            "fax_number": "518-373-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONNELL AND MCMAHON PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-30",
        "last_updated": "2015-01-02",
        "status": "A",
        "authorized_official_last_name": "MCDONNELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "518-373-1181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "48803",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "053734",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "054764",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "054477",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "056708",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "057555",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "057644",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Smile Lodge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; 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.