Rita Domasica, D.M.D.
Individual provider Active NPI General Practice Dentistry · Clinton, NJ
NPI 1003925199 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003925199
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 22DI01971200 (NJ)
- Practice address
- 99 Grayrock Rd Ste 204
Clinton, NJ 08809-1076 - Phone
- (908) 638-5242
- Fax
- (908) 638-8262
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160311000266 | NJ | Order and Referring Only - Dentist |
6305142720 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI01971200 | NJ | Yes |
Addresses
Primary practice location
99 Grayrock Rd Ste 204
Clinton, NJ 08809-1076
Mailing address
99 Grayrock Rd Ste 204
Clinton, NJ 08809-1076
Phone (908) 638-5242
Other providers in Clinton, NJ
- Steven James Decasperis
- Daniel Alejandrino Delara
- Alexandra Destefano
- Michael Pasquale Dilullo
- Jodi Nichole Dinnerman
- Brian Donnelly
- Laure Duval
- Annette E. Ehasz
- Nancy A Erb
- Jennifer Fahr
All providers in Clinton, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.