Individual provider Active NPI

Gregory A. McDonald, D.D.S.

  • General Practice Dentistry
  • Cincinnati, OH
National Provider Identifier
1902098163
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
018367 Issued in OH
Practice address
11740 Hamilton Ave
Suite a
Cincinnati, OH 45231-1129
Phone
(513) 825-7570
Fax
(513) 825-7999
NPI assigned
Aug 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 018367 OH Primary

Addresses

Primary practice location

11740 Hamilton Ave
Suite a
Cincinnati, OH 45231-1129

Mailing address

11740 Hamilton Ave
Suite a
Cincinnati, OH 45231-1129
Phone (513) 825-7570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20160509002439 OH Order and Referring Only - DentistPractitioner - Dentist 7517256803

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018367OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Ohio Dental Associates L.L.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1902098163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11740 HAMILTON AVE",
            "address_2": "SUITE A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452311129",
            "telephone_number": "513-825-7570",
            "fax_number": "513-825-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11740 HAMILTON AVE",
            "address_2": "SUITE A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452311129",
            "telephone_number": "513-825-7570",
            "fax_number": "513-825-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "GREGORY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "018367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.