Mark a. Dougherty, D.D.S., Inc

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

MARK A. DOUGHERTY, D.D.S., INC

Practice address

17300 Yorba Linda Blvd Ste H
Yorba Linda, CA 92886-3810

Phone

(714) 993-1194

Fax

(714) 524-0397

NPI assigned

Mar 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Dougherty, D.D.S.NPI 1518053768

Title

President

Phone

(714) 993-1194

Specialties & licenses 1

Addresses

Practitioners 2

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

• Mark Dougherty, D.D.S.

  • Periodontics
  • Yorba Linda, CA
  • NPI 1518053768
  NPD (past) Authorized official
• Sandy Ku, DMD

  • Periodontics
  • Yorba Linda, CA
  • NPI 1083375695
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164540696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 YORBA LINDA BLVD STE H",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863810",
            "telephone_number": "714-993-1194",
            "fax_number": "714-524-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 YORBA LINDA BLVD STE H",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863810",
            "telephone_number": "714-993-1194",
            "fax_number": "714-524-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. DOUGHERTY, D.D.S., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-993-1194",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Madden, LMFT
• Mary Denise Maldonado-Plascencia, LCSW
• Masood Parvez Malik, PHARM.D.
• Pryscilla Lyhn Gandia Mann, LCSW
• James Dean Marin, RD
• Mark Allen Physical Therapy, a Professional Corporation
• Lynn Francis Marran, OD
• Martin Stauber MD, a Medical Corporation
• Keith L Martin, M.D.
• Megan Martin, PHARM D

• Periodontics in Yorba Linda, CA
• Providers in Yorba Linda, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.