Maureen Roberta Dornan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30107 Issued in CA

Practice address

13422 Newport Ave
Ste B
Tustin, CA 92780-3746

Phone

(714) 544-2020

Fax

(714) 544-7620

NPI assigned

Jun 21, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Dentist

Education

Other, 1981

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• M Roberta Dornan DDS Inc

  • General Practice Dentistry
  • Tustin, CA
  • NPI 1023370426
  Medicare reassignment NPD Authorized official
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  NPD (past)

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1477559896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13422 NEWPORT AVE",
            "address_2": "STE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803746",
            "telephone_number": "714-544-2020",
            "fax_number": "714-544-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13422 NEWPORT AVE",
            "address_2": "STE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803746",
            "telephone_number": "714-544-2020",
            "fax_number": "714-544-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNAN",
        "first_name": "MAUREEN",
        "middle_name": "ROBERTA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Donohoe
• Monica Donoso
• Norma Lee Donovan, LMFT
• Robin K Dore, MD
• Rebecca Joann Dorfman, LMFT
• Lucia Marion Doshi, RD/RDN, MPH
• Dr Desai Dental Corp
• Dr Jack Pai DDS Inc
• Dr Jeffrey Lee MD DMD
• Dr Samuel Dental Corp

• General Practice Dentistry in Tustin, CA
• Providers in Tustin, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.