Glen McDonald Jr., D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

3442 Issued in AL

Practice address

5820 McClellan Blvd
Anniston, AL 36206-8466

Phone

(256) 820-5570

Fax

(256) 820-5322

NPI assigned

Mar 14, 2014

Sex

Male

Sole proprietor

Yes

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 AL

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

Practice roles

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.

• Glen B McDonald DDS PC

  • Dentist
  • Anniston, AL
  • NPI 1427126069
  NPD (past) Authorized official
• Kinsey Dental Associates PC

  • Dental Clinic/Center
  • Anniston, AL
  • NPI 1063926426
  NPD (past)

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1861818817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 MCCLELLAN BLVD",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362068466",
            "telephone_number": "256-820-5570",
            "fax_number": "256-820-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 MCCLELLAN BLVD",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362068466",
            "telephone_number": "256-820-5570",
            "fax_number": "256-820-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "GLEN",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "3442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly McConnell, CRNA
• Lance McConnell
• Robin McCreary
• Clarence Eugene McDanal Jr., M.D.
• Cheyann McDaniel
• Stephanie Nicole McElroy, DMD, MS
• Erin McIntosh, M.S.,CCC-SLP
• Lashieka Renea McKinney
• Nadia Jonelle McKitty, M.D.
• Jennifer Lynn McLaughlin, P.T.

• Dentist in Anniston, AL
• Providers in Anniston, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.