Provider Demographics
NPI:1952304941
Name:MCMAHON, PAMELA ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ANN
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:ANN
Other - Last Name:GOULD-MCMAHON-LYMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6589 S KINGS RANCH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85118-2934
Mailing Address - Country:US
Mailing Address - Phone:480-288-1800
Mailing Address - Fax:480-288-1888
Practice Address - Street 1:6589 S KINGS RANCH RD STE 101
Practice Address - Street 2:
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85118-2934
Practice Address - Country:US
Practice Address - Phone:480-288-1800
Practice Address - Fax:480-288-1888
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD52601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice