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NPI Code Detail

MEDICARE: JOHN SANFORD MCDONALD DDSMS

MEDICARE: JOHN SANFORD MCDONALD DDSMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0101XAnatomic Pathology Physician30-016274OH
21223S0112XOral and Maxillofacial Surgery (Dentist)30-016274OH

General Provider Information

NPI Number : 1558360461
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN SANFORD MCDONALD DDSMS
Provider Business Mailing Address
First Line : 222 PIEDMONT AVE
Second Line : SUITE 8400
City : CINCINNATI
State : OH
Zip : 45219-4231
Country : US
Telephone Number : 513-475-7662
Fax Number : 513-475-7666
Provider Business Practice Location Address
First Line : 222 PIEDMONT AVE
Second Line : SUITE 8400
City : CINCINNATI
State : OH
Zip : 45219-4231
Country : US
Telephone Number : 513-475-7662
Fax Number : 513-475-7666
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 02/25/2016

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Directions to “ JOHN SANFORD MCDONALD DDSMS” Practice Location

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