Daniel John Macdonald, D.M.D.

Individual provider Active NPI General Practice Dentistry · Archdale, NC

NPI 1831501386 · NPPES record last updated Jun 2, 2014

Key facts

NPI
1831501386
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
9750 (NC)
Practice address
9924 US Highway 311
Archdale, NC 27263-8826
Phone
(336) 434-3186
Fax
(336) 434-3189
NPI assigned
Jun 2, 2014
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160107002588 NC Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
6204138209

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
9750NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Keith T. Macdonald General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9750 NC Yes

Addresses

Primary practice location

9924 US Highway 311
Archdale, NC 27263-8826

Mailing address

9924 US Highway 311
Archdale, NC 27263-8826
Phone (336) 434-3186

Other providers in Archdale, NC

All providers in Archdale, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.