Individual provider Active NPI

David William Macdonald, D.D.S.

  • Pediatric Dentistry
  • Fresno, CA
National Provider Identifier
1982138269
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
106580 Issued in CA
Practice address
4220 W Figarden Dr Ste 101
Fresno, CA 93722-6071
Phone
(559) 439-5200
NPI assigned
Apr 13, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 106580 CA Primary

Addresses

Primary practice location

4220 W Figarden Dr Ste 101
Fresno, CA 93722-6071

Mailing address

4220 W Figarden Dr Ste 101
Fresno, CA 93722-6071
Phone (559) 439-5200

Other practice location 1

7525 N Cedar Ave Ste 105
Fresno, CA 93720-2698
Phone (559) 439-6600

Other practice location 2

1900 Shaw Ave Ste 101
Clovis, CA 93611-4209
Phone (559) 439-5300

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

LicenseStateTypeSpecialty
106580CAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1982138269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 W FIGARDEN DR STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937226071",
            "telephone_number": "559-439-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 W FIGARDEN DR STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937226071",
            "telephone_number": "559-439-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7525 N Cedar Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937202698",
            "country_code": "US",
            "telephone_number": "559-439-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 Shaw Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936114209",
            "country_code": "US",
            "telephone_number": "559-439-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "DAVID",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "106580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.