Lauren A McDonough, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

03993 Issued in NH

Practice address

1679 NW Saint Lucie West Blvd
Port St Lucie, FL 34986-2106

Phone

(772) 224-3090

Fax

(772) 878-6350

NPI assigned

Jul 3, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1568802510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1679 NW SAINT LUCIE WEST BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862106",
            "telephone_number": "772-224-3090",
            "fax_number": "772-878-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1679 NW SAINT LUCIE WEST BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862106",
            "telephone_number": "772-224-3090",
            "fax_number": "772-878-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "LAUREN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "03993",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20301",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danny Leonard McCullough, MPT
• Taylor McCune
• Anita McCurry, SLP
• Lindsay Ann McDaniel, MHS, CRC, RMHCI
• Brian McDermott, PTA
• Richard F McFague, M.D
• Jeffrey Mark McFarlane, ARNP
• Stephanie McGloin
• Elizabeth M. McGoogan, ARNP
• Kraig Collier McHardy

• Dentist in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.