Mc Donough, Shaelan
Mc Donough, Shaelan is an individual health care provider with primary practice located at 593 N Moorpark Rd Ste B , Thousand Oaks CA 91360-3732. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Mc Donough, Shaelan can be contacted via phone (702) 205-5398.Contact Information
Primary practice address
593 N Moorpark Rd Ste B
Thousand Oaks CA 91360-3732
Phone: (702) 205-5398
Fax: (805) 494-5322
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 56210 | California |
Profile Details
| NPI number | 1265630214 |
|---|---|
| LBN Legal business name | Mc Donough, Shaelan |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2007 |
| Last updated | Aug 9th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265630214 | NPPES |
| Nebraska | MEDICAID | D7298 |
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