MEDICARE: DR. JAMES H MACDOWELL 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	122300000X	Dentist	48830	CA
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	48830	CA

General Provider Information

NPI Number	:	1629053798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES H MACDOWELL D.D.S.

Provider Business Mailing Address
First Line	:	11710 EL CAMINO REAL STE 150
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92130-2245
Country	:	US
Telephone Number	:	858-621-3568
Fax Number	:

Provider Business Practice Location Address
First Line	:	11710 EL CAMINO REAL STE 150
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92130-2245
Country	:	US
Telephone Number	:	858-621-3568
Fax Number	:

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	01/10/2025

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