M ROBERTA DORNAN DDS INC
NPI 1023370426
Dentist - General Practice in Tustin, CA

Q: What is M Roberta Dornan Dds Inc's NPI number?

The NPI number for M Roberta Dornan Dds Inc is 1023370426. It was assigned to this organization in the NPPES registry on June 12, 2012.

Q: What is M Roberta Dornan Dds Inc's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since June 12, 2012

13422 NEWPORT AVE STE B, TUSTIN, CA 92780(714) 544-2020(714) 544-7620 Get Directions Write a Review

NPPES record last updated: February 8, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About M Roberta Dornan Dds Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

M ROBERTA DORNAN DDS INC (NPI 1023370426) is a healthcare organization registered as a general practice in Tustin, California and active in the NPI registry since June 2012. The organization lists Maureen Roberta Dornan, Owner, as its authorized official.

NPPES Registry Identity

NPI1023370426

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameM ROBERTA DORNAN DDS INC

Location Address13422 NEWPORT AVE STE BTustin, CA 92780-3746

Mailing Address13422 Newport Ave Ste BTustin, CA 92780-3746 · (714) 544-2020 · Fax (714) 544-7620

Phone(714) 544-2020

Fax(714) 544-7620

Organization SubpartNo

Authorized OfficialMaureen Roberta DornanOwner · (714) 544-2020

Enumeration DateJune 12, 2012

Last NPPES UpdateFebruary 8, 2018

✔ NPI 1023370426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · 30107

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

13422 NEWPORT AVE STE B, Tustin, CA 92780

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

M Roberta Dornan Dds Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateCaliforniaEnrollment IDO20121105000596Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to M Roberta Dornan DDS Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Maureen Dornan, D.D.S.

Dentist

NPI 1477559896

13422 NEWPORT AVE STE B
Tustin, CA 92780

(714) 544-2020

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is M Roberta Dornan Dds Inc's NPI number?

The NPI number for M Roberta Dornan Dds Inc is 1023370426. It was assigned to this organization in the NPPES registry on June 12, 2012.

Where is M Roberta Dornan Dds Inc located?

M Roberta Dornan Dds Inc is located at 13422 Newport Ave Ste B, Tustin, CA 92780. The listed phone number is (714) 544-2020.

What is M Roberta Dornan Dds Inc's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is M Roberta Dornan Dds Inc enrolled in Medicare?

Yes. M Roberta Dornan Dds Inc is registered in the Medicare PECOS enrollment system.

When is M Roberta Dornan Dds Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through M Roberta Dornan Dds Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dentist) reassigns their Medicare billing to M Roberta Dornan Dds Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for M Roberta Dornan Dds Inc was last updated on February 8, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.