Ronald Craig Maddox, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

32353 Issued in CA

Practice address

1111 W Covina Blvd
Suite 110
San Dimas, CA 91773-3205

Phone

(909) 394-7710

Fax

(909) 394-7703

NPI assigned

Jun 18, 2007

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 CA

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

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861697112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SCOTIA SEA",
            "city": "NEWPORT COAST",
            "state": "CA",
            "postal_code": "926572104",
            "telephone_number": "949-636-1911",
            "fax_number": "949-497-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W COVINA BLVD",
            "address_2": "SUITE 110",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733205",
            "telephone_number": "909-394-7710",
            "fax_number": "909-394-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "RONALD",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "32353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Earl Justin Macaso, R.D.
• Rosa Macias-Pineda
• George M Madanat, MD
• Lana Madanat, MSN, RN, CPNP
• Michael G Madanat, M.D.
• Richard Jackson Magallon, MD
• Samantha Magdalik
• Magdy Sarieldin
• Maher Al-Bouz Dental Corp
• Richard Lloyd Malinick, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.