Joanne Lynne S. Fernando,D.M.D.,Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54582 Issued in CA

Legal business name

JOANNE LYNNE S. FERNANDO,D.M.D.,INC

Doing business as

Tustin Dental Wellness

Practice address

13962 Newport Ave Ste C
Tustin, CA 92780-7827

Phone

(714) 573-1086

Fax

(714) 573-8239

NPI assigned

Oct 25, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Joanne Lynne Santarina Fernando, D.M.D.NPI 1811161292

Title

President

Phone

(714) 573-1086

Specialties & licenses 1

Addresses

Other names 1

• Tustin Dental Wellness Doing business as

Locations

Practitioners 1

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

• Joanne Lynne Santarina Fernando, DMD

  • General Practice Dentistry
  • Tustin, CA
  • NPI 1811161292
  NPD (past) Authorized official

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1144520248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13962 NEWPORT AVE STE C",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807827",
            "telephone_number": "714-573-1086",
            "fax_number": "714-573-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13962 NEWPORT AVE STE C",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807827",
            "telephone_number": "714-573-1086",
            "fax_number": "714-573-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNE LYNNE S. FERNANDO,D.M.D.,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "FERNANDO",
        "authorized_official_first_name": "JOANNE LYNNE",
        "authorized_official_middle_name": "SANTARINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-573-1086",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tustin Dental Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Crystal Johnson, RN, PMHNP-BC

• 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 May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.