Shaelan MC Donough, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

56210 Issued in CA

Practice address

593 N Moorpark Rd Ste B
Thousand Oaks, CA 91360-3732

Phone

(702) 205-5398

Fax

(805) 494-5322

NPI assigned

Jul 10, 2007

Last updated

Aug 9, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Huss and Lambridis Dental Corporation

  dba East Oaks Dental Group

  • General Practice Dentistry
  • Thousand Oaks, CA
  • NPI 1932296480
  NPD (past)

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1265630214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 N MOORPARK RD STE B",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603732",
            "telephone_number": "702-205-5398",
            "fax_number": "805-494-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 N MOORPARK RD STE B",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603732",
            "telephone_number": "702-205-5398",
            "fax_number": "805-494-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MC DONOUGH",
        "first_name": "SHAELAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D7298",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace T Mayemura
• Natalie Peyton Mayer, NONE
• Ryan Mayhew, BCBA
• Michelle Maynard, MPT, DPT
• Mark H Mazur, MD
• Justin Andrew McAlister
• Caitlin McCall-Rhodes
• Steven P McCarthy, M.D.
• Benjamin McConnaughy
• Frederick James McCord, D.D.S.

• Dentist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.