Active NPI
Michael Raymond McMahon, D.D.S.
- Dentist
- Chardon, OH
National Provider Identifier
1902058803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14579
- Practice address
- 401 South St
Suite 3a
Chardon, OH 44024-2805 - Phone
- (440) 286-6019
- Fax
- (440) 285-2602
- NPI assigned
- Oct 22, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14579 | OH | Primary |
Addresses
Primary practice location
401 South St
Suite 3a
Chardon, OH 44024-2805
Mailing address
401 South St
Suite 3a
Chardon, OH 44024-2805
Phone (440) 286-6019
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14579 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224633600000",
"number": "1902058803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 SOUTH ST",
"address_2": "SUITE 3A",
"city": "CHARDON",
"state": "OH",
"postal_code": "440242805",
"telephone_number": "440-286-6019",
"fax_number": "440-285-2602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 SOUTH ST",
"address_2": "SUITE 3A",
"city": "CHARDON",
"state": "OH",
"postal_code": "440242805",
"telephone_number": "440-286-6019",
"fax_number": "440-285-2602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHON",
"first_name": "MICHAEL",
"middle_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-22",
"last_updated": "2008-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "14579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chardon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.