Stephen Donoghue, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS105793 Issued in CA

Practice address

13105 Jamboree Rd
Tustin, CA 92782-9150

Phone

(714) 505-4867

NPI assigned

Mar 31, 2021

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Stephen Donoghue DDS Inc

  • Dental Clinic/Center
  • Tustin, CA
  • NPI 1851176846
  NPD Authorized official
• Zahra H. Ezzy D.D.S. Inc

  • Dental Clinic/Center
  • Tustin, CA
  • NPI 1295585800
  NPD (past)

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1770161747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13105 JAMBOREE RD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927829150",
            "telephone_number": "714-505-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13105 JAMBOREE RD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927829150",
            "telephone_number": "714-505-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOGHUE",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS105793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Docs for(4) Kids Medical Office
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• Victoria Dominguez Ashimine, MFT
• Miguel A Dominguez, M.D.
• Alana Donckels
• Ashley Donohoe
• Monica Donoso
• Norma Lee Donovan, LMFT
• Robin K Dore, MD
• Rebecca Joann Dorfman, LMFT

• 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 Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.