Healthcare Provider Details

I. General information

NPI: 1710817044
Provider Name (Legal Business Name): PRESTON MACDONALD DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92055 14TH ST
OCEANSIDE CA
92058
US

IV. Provider business mailing address

200 MERCY CIRCLE CREDENTIALING OFFICE
CAMP PENDLETON CA
92055
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-5870
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14283945-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: