Individual provider Active NPI

Michelle Marie Pashley, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Laguna Hills, CA
National Provider Identifier
1396843009
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
60053 Issued in CA
Practice address
24953 Paseo de Valencia Ste 1C
Laguna Hills, CA 92653-4337
Phone
(949) 768-4071
NPI assigned
Sep 20, 2006
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dental AnesthesiologyGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0004X 137.000670.019.02690 CA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 019026904 IL
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 60053 CA Primary

Addresses

Primary practice location

24953 Paseo de Valencia Ste 1C
Laguna Hills, CA 92653-4337

Mailing address

10942 Harrogate PL
Santa Ana, CA 92705-2353
Phone (312) 925-0882

Other practice location 1

6305 W 95th St
Oak Lawn, IL 60453-2255
Phone (708) 425-4300

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201201001577 CA Practitioner - Maxillofacial SurgeryPractitioner - Dentist 1355433673 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
137.000670.019.02690CAMDDentist Anesthesiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Quoc L. Nguyen, D.D.S. a Professional Dental Corporation Multi-Specialty CurrentSince Nov 1, 2020 Accepting new patients
Hochstadter Isaacson Cherny Dumanis & Assoc Maxillo Surgery LTD Oral and Maxillofacial Surgery PastSince Aug 15, 2005 Accepting new patients
Board of Trustees of the University of Illinois Oral and Maxillofacial Surgery Past Accepting new patients

Locations

24953 Paseo de Valencia
Ste 22B
Laguna Hills, CA 92653
Phone (949) 768-4071

24953 Paseo de Valencia
Ste 1C
Laguna Hills, CA 92653
Phone (949) 446-9325

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1396843009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10942 HARROGATE PL",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927052353",
            "telephone_number": "312-925-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24953 PASEO DE VALENCIA STE 1C",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534337",
            "telephone_number": "949-768-4071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6305 W 95th St",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532255",
            "country_code": "US",
            "telephone_number": "708-425-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASHLEY",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CA",
            "license": "137.000670.019.02690",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019026904",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "60053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.