Brent C. McDonald, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7384 Issued in KY

Practice address

608 Knox St
Barbourville, KY 40906-1304

Phone

(606) 546-6711

Fax

(606) 546-2574

NPI assigned

Nov 20, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

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.

• Knox Family Dentistry, P.S.C.

  • General Practice Dentistry
  • Barbourville, KY
  • NPI 1467598912
  NPD (past) Authorized official

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1902970171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 KNOX ST",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061304",
            "telephone_number": "606-546-6711",
            "fax_number": "606-546-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 KNOX ST",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061304",
            "telephone_number": "606-546-6711",
            "fax_number": "606-546-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "BRENT",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60073848",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David T Malone, DPH
• Anitta Martin
• Donna Faye Martin
• Kaylee Mathis
• Lauren Mayton, PHARM.D.
• Mdsrus Limited Liability Company
• Lynn Medlin, OTR/L
• Memorial Hospital, Inc.
• Bailey Messer, BS
• Gina A Messer, DMD

• General Practice Dentistry in Barbourville, KY
• Providers in Barbourville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.