Individual provider Active NPI

Kashif Ismail, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Tustin, CA
National Provider Identifier
1235324880
Registry record updated Jun 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
56333 Issued in CA
Practice address
13297 Jamboree Rd
Tustin, CA 92782-9159
Phone
(714) 730-6600
Fax
(951) 776-1571
NPI assigned
Sep 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5568 NV
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 56333 CA Primary

Addresses

Primary practice location

13297 Jamboree Rd
Tustin, CA 92782-9159

Mailing address

13297 Jamboree Rd
Tustin, CA 92782-9159
Phone (714) 730-6600

Other practice location 1

136 W Nuevo Rd Ste G
Perris, CA 92571-0859
Phone (951) 943-0666

Other practice location 2

31577 Canyon Estates Dr Ste 215
Lake Elsinore, CA 92532-0473
Phone (951) 471-0194

Other practice location 3

1810 Fullerton Ave Ste 202
Corona, CA 92881-3109
Phone (951) 736-5700

Other practice location 4

1130 N Pepper Ave Ste C
Colton, CA 92324-6717
Phone (909) 422-0007

Other practice location 5

18876 Van Buren Blvd Ste 200
Riverside, CA 92508-9114
Phone (951) 776-1376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5568NVMDDentist
56333CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lustig and Young Dental Corporation Orthodontics and Dentofacial Orthopedics CurrentSince Jun 30, 2024 Accepting new patients

Locations

1130 N Pepper Ave
Ste C
Colton, CA 92324
Phone (909) 422-0007

1810 Fullerton Ave
Ste 202
Corona, CA 92881
Phone (951) 736-5700

31577 Canyon Estates Dr
Ste 215
Lake Elsinore, CA 92532
Phone (951) 471-0194

136 W Nuevo Rd
Ste G
Perris, CA 92571
Phone (951) 943-0666

13297 Jamboree Rd
Tustin, CA 92782
Phone (714) 730-6600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1235324880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13297 JAMBOREE RD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927829159",
            "telephone_number": "714-730-6600",
            "fax_number": "951-776-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13297 JAMBOREE RD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927829159",
            "telephone_number": "714-730-6600",
            "fax_number": "951-776-1571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 W Nuevo Rd Ste G",
            "address_purpose": "LOCATION",
            "city": "Perris",
            "state": "CA",
            "postal_code": "925710859",
            "country_code": "US",
            "telephone_number": "951-943-0666",
            "fax_number": "951-776-1571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31577 Canyon Estates Dr Ste 215",
            "address_purpose": "LOCATION",
            "city": "Lake Elsinore",
            "state": "CA",
            "postal_code": "925320473",
            "country_code": "US",
            "telephone_number": "951-471-0194",
            "fax_number": "951-776-1571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1810 Fullerton Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928813109",
            "country_code": "US",
            "telephone_number": "951-736-5700",
            "fax_number": "951-776-1571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1130 N Pepper Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923246717",
            "country_code": "US",
            "telephone_number": "909-422-0007",
            "fax_number": "951-776-1571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18876 Van Buren Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925089114",
            "country_code": "US",
            "telephone_number": "951-776-1376",
            "fax_number": "951-776-1571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "KASHIF",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-06",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "5568",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "56333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2024; 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.