Mark William McDonough, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DI-18916 Issued in NJ

Practice address

245 South Main Street
Pennington, NJ 08534

Phone

(609) 730-1414

Fax

(609) 730-1456

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891889432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 SOUTH MAIN STREET",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "08534",
            "telephone_number": "609-730-1414",
            "fax_number": "609-730-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 SOUTH MAIN STREET",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "08534",
            "telephone_number": "609-730-1414",
            "fax_number": "609-730-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "DI-18916",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS027596L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mbrace Yourself, LLC
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• Andrea Helen McClung, CRNP
• Lauren Alyse McDaniel, CNM
• Elizabeth Lynn McDonnell, M.D.
• Caitlin McElvaine, ATC
• Kelly McGowan, CM
• Nenita Parrilla McIntosh, MD
• Tatiana McKenna, M.D.
• Michael Joseph McLaughlin, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Pennington, NJ
• Providers in Pennington, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.