Kirk B McDonald, D.D.S.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

12551 Issued in MA

Practice address

1493 Cambridge St
Cambridge, MA 02139-1047

Phone

(617) 665-3990

NPI assigned

Jun 25, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1851773873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WINDSOR ST STE 2",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393648",
            "telephone_number": "617-665-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047",
            "telephone_number": "617-665-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "KIRK",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "12551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Arrington McCoy, LMHC
• Roderick Lawrence McCoy, MD, PHD
• Anne McCue, PH.D.
• Joanne T. McDevitt, RNCS
• Cameron Allen McDonald, RD
• Mary McDonald, LICSW
• Mary Colleen McDonald
• Elise Marie McDonnell, MSW, LICSW
• Brenda McDonough, RN
• Janice M McDonough, RN CS

• Student in an Organized Health Care Education/Training Program in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.