Provider Demographics
NPI:1285075838
Name:L. STEPHEN VAUGHAN, D.D.S., M.D. INC
Entity type:Organization
Organization Name:L. STEPHEN VAUGHAN, D.D.S., M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:VAUGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MD
Authorized Official - Phone:949-297-8880
Mailing Address - Street 1:26730 TOWNE CENTRE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2842
Mailing Address - Country:US
Mailing Address - Phone:949-297-8880
Mailing Address - Fax:949-287-8880
Practice Address - Street 1:26730 TOWNE CENTRE DR STE 105
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2842
Practice Address - Country:US
Practice Address - Phone:949-297-8880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOMS 611223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty