DR. MICAH D DONLON DMD
NPI 1881117356
Dentist - Orofacial Pain in Lexington, KY

NPI Status: Active since July 17, 2017

Contact Information

740 S LIMESTONE STE E214
LEXINGTON, KY
ZIP 40536
Phone: (859) 323-5500
Fax: (859) 323-0001

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  • Individual
  • Female
  • Dentist
  • Orofacial Pain
  • Accepts Insurance
  • PECOS Enrolled

About MICAH DONLON

This page provides the complete NPI Profile along with additional information for Micah Donlon, a provider established in Lexington, Kentucky with a medical specialization in Dentist, focusing in orofacial pain . The healthcare provider is registered in the NPI registry with number 1881117356 assigned on July 2017. The practitioner's primary taxonomy code is 1223X2210X with license number 10818 (KY). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1881117356
Provider Name
DR. MICAH D DONLON DMD
Gender
Female
Entity Type
Individual
Location Address
740 S LIMESTONE STE E214 LEXINGTON, KY 40536
Location Phone
(859) 323-5500
Location Fax
(859) 323-0001
Mailing Address
740 S LIMESTONE LEXINGTON, KY 40536
Mailing Phone
(859) 323-5500
Is Sole Proprietor?
No
Enumeration Date
07-17-2017
Last Update Date
10-28-2024
Code Navigator

A dentist like Micah Donlon is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Secondary Locations

  • 4122 Shelbyville Rd Ste A
    Louisville, KY 40207
    (843) 860-1220

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist Orofacial Pain

Taxonomy Code
1223X2210X
Type
Dental Providers
License No.
10818
License State
KY
Taxonomy Description
A dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, and chronic head/neck pain. The dentist has successfully completed an accredited postdoctoral orofacial pain residency training program for dentists of two or more years duration, in accord with the Commission on Dental Accreditation's Standards for Orofacial Pain Residency Programs, and/or meets the requirements for examination and board certification by the American Board of Orofacial Pain.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1122300000XDental Providers

Dentist

10818 (KY)
2122300000XDental Providers

Dentist

8976 (SC)
3122300000XDental Providers

Dentist

DN25572 (FL)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BEST Life Preferred Dental Plan - PPO
  • BEST Life Superior Dental Plan - PPO
  • BEST Life Essental Preferred Dental Plan - PPO
  • BEST Life Essental Value Dental Plan - PPO
  • BEST Life Essential Basic Dental Plan - PPO
  • BEST Life Essential Basic Dental - PPO
  • BEST Life Essential Basic Dental Plan - Indemnity
  • BEST Life Essential Basic Dental Plan - PPO
  • BEST Life Essential Value Dental Plan - PPO
  • BEST Life Essential Value Dental - PPO
  • BEST Life Essential Value Dental Plan - Indemnity
  • BEST Life Essential Value Dental Plan - PPO
  • BEST Life Preferred Dental - PPO
  • BEST Life Preferred Dental Plan - PPO
  • BEST Life Preferred Dental Plan - Indemnity
  • BEST Life Preferred Dental Plan - PPO
  • BEST Life Superior Dental - PPO
  • BEST Life Superior Dental Plan - PPO
  • BEST Life Superior Dental Plan - Indemnity
  • BEST Life Superior Dental Plan - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • Choice PPO Basic - PPO
  • Choice PPO Basic Kids - PPO
  • Choice PPO Plus - PPO
  • Choice PPO Premium - PPO
  • Choice PPO Premium Kids - PPO
  • Choice PPO Preventive - PPO
  • EMI Health Advantage Co-Pay - PPO
  • EMI Health Advantage PPO - PPO
  • EMI Health Advantage PPO Low - PPO
  • EMI Health Premier PPO (High) - PPO
  • EMI Health Premier PPO (Low) - PPO
  • Guardian Basics for Familes and Individuals - PPO
  • Guardian Essentials for Families and Individuals - PPO
  • Guardian Preventive Plus for Families and Individuals - PPO
  • Guardian Select for Families and Individuals - PPO
  • HRI Essential Plus Plan - HMO
  • HRI Essential Plus Plan - PPO
  • HRI Preventive Family Plan - HMO
  • HRI Preventive Family Plan - PPO
  • HRI Total Care Plan - HMO
  • HRI Total Care Plan - PPO
  • Humana Dental Smart Choice - PPO
  • Humana Dental Smart Choice - Basic - PPO
  • Humana Dental Smart Choice - High - PPO
  • Humana Dental Smart Choice - Lite - PPO
  • Humana Dental Smart Choice - Low - PPO
  • Paramount Dental Essential Plus Plan - EPO
  • Paramount Dental Preventive Family Plan - EPO
  • Paramount Dental Total Care Plan - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Micah Donlon is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 40536 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.24
  • Minimum New Patient Price $52.76
  • Maximum New Patient Price $162.27
  • Average New Patient Copayment $20.56
  • Minimum New Patient Copayment $13.19
  • Maximum New Patient Copayment $40.56

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $66.24
  • Minimum Established Patient Price $16.53
  • Maximum Established Patient Price $131.99
  • Average Established Patient Copayment $16.56
  • Minimum Established Patient Copayment $4.13
  • Maximum Established Patient Copayment $32.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1881117356, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
1
Unchanged
Pos 5
1
Doubled → 2
Pos 6
1
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
3
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 1 → 2 7 → 14 → 5 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 1 + 6 + 1 + 2 + 1 + 1 + 4 + 3 + 1 + 0 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1881117356.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1881117356, enumerated as an "individual" on July 17, 2017.

The provider is located at 740 S LIMESTONE STE E214 LEXINGTON, KY 40536 and the phone number is (859) 323-5500.

Dentist with taxonomy code 1223X2210X and a focus in Orofacial Pain.

The provider might be accepting Accepts: BEST Life, Blue Cross and Blue Shield of Montana,. Please consult your insurance carrier or call the provider to verify.