M Roberta Dornan DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30107 Issued in CA

Legal business name

M ROBERTA DORNAN DDS INC

Practice address

13422 Newport Ave Ste B
Tustin, CA 92780-3746

Phone

(714) 544-2020

Fax

(714) 544-7620

NPI assigned

Jun 12, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maureen Roberta Dornan, D.D.S.NPI 1477559896

Title

Owner

Phone

(714) 544-2020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maureen Roberta Dornan, D.D.S.

  • General Practice Dentistry
  • Tustin, CA
  • NPI 1477559896
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1023370426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13422 NEWPORT AVE STE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803746",
            "telephone_number": "714-544-2020",
            "fax_number": "714-544-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13422 NEWPORT AVE STE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803746",
            "telephone_number": "714-544-2020",
            "fax_number": "714-544-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M ROBERTA DORNAN DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-12",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "DORNAN",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "ROBERTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-544-2020",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Loung Ly
• Maura Lynch-Loftus, LCSW
• Carol Joanne Lyskoski
• William Christopher Sir Lyv, PT, DPT
• M Garcia Chiropractic Corp
• M. Arthur Charles, M.D.
• M.K. Hoang O.D. Inc.
• Catherine Sohra Ma
• Janet Ma, (MSN, FNP)
• Susan Ma

• General Practice Dentistry in Tustin, CA
• Providers in Tustin, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.