Healthcare Provider Details

I. General information

NPI: 1336489103
Provider Name (Legal Business Name): JOSEPH KYLE DONAGHEY,DMD,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2013
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 NORTH DEAN ROAD
AUBURN AL
36830
US

IV. Provider business mailing address

836 NORTH DEAN ROAD
AUBURN AL
36830
US

V. Phone/Fax

Practice location:
  • Phone: 334-821-8800
  • Fax: 334-821-8838
Mailing address:
  • Phone: 334-821-8800
  • Fax: 334-821-8838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSPEH KYLE DONAGHEY
Title or Position: OWNER
Credential: D.M.D
Phone: 334-821-8800