Individual provider Active NPI

Myron Lee Donesky, D.D.S.

  • General Practice Dentistry
  • Novato, CA
National Provider Identifier
1831273143
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34835 Issued in CA
Practice address
7250 Redwood Blvd
Suite 210
Novato, CA 94945-3268
Phone
(415) 897-9642
Fax
(415) 897-4640
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 34835 CA Primary

Addresses

Primary practice location

7250 Redwood Blvd
Suite 210
Novato, CA 94945-3268

Mailing address

7250 Redwood Blvd
Suite 210
Novato, CA 94945-3268
Phone (415) 897-9642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
34835CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831273143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7250 REDWOOD BLVD",
            "address_2": "SUITE 210",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949453268",
            "telephone_number": "415-897-9642",
            "fax_number": "415-897-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 REDWOOD BLVD",
            "address_2": "SUITE 210",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949453268",
            "telephone_number": "415-897-9642",
            "fax_number": "415-897-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONESKY",
        "first_name": "MYRON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.