MEDICARE: DR. KRISTIN KAY MCNAMARA D.D.S.

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
1	1223G0001X	General Practice Dentistry	2901018436	MI
2	1223P0106X	Oral and Maxillofacial Pathology Dentistry	2536	OH
3	1223P0106X	Oral and Maxillofacial Pathology Dentistry	30.023131	OH

General Provider Information

NPI Number	:	1366659658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTIN KAY MCNAMARA D.D.S.

Provider Business Mailing Address
First Line	:	1195 WILLARD AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43212-3570
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 MARCONI BLVD STE 308
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-2329
Country	:	US
Telephone Number	:	503-906-7300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	05/06/2025

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