Active NPI
Kashif Ismail, D.M.D.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Tustin, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 56333
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 5568 | NV | MD | Dentist |
| 56333 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lustig and Young Dental Corporation | Orthodontics and Dentofacial Orthopedics | Current | 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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Tustin, CA
- NPI 1255634903
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.