Individual provider Active NPI

Jeffrey S. Dombrowski, D.D.S.,M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Carrollton, TX
National Provider Identifier
1023088143
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
28274 Issued in TX
Practice address
1813 Golden Trail Court
Suite 100
Carrollton, TX 75010
Phone
(972) 395-7630
Fax
(972) 395-7625
NPI assigned
Jan 23, 2006
Last updated
Jan 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28274 TX
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 7425 CO
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 28274 TX Primary

Addresses

Primary practice location

1813 Golden Trail Court
Suite 100
Carrollton, TX 75010

Mailing address

1813 Golden Trail Court
Suite 100
Carrollton,, TX 75010
Phone (972) 395-7630

Other identifiers 1

IdentifierTypeStateIssuer
02074250MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28274TXMDDentist
7425COMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Robert J. Naples, DDS PA Oral and Maxillofacial Surgery Past Accepting new patients
Michael Kunkel DDS Professional LLC Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1023088143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 GOLDEN TRAIL COURT",
            "address_2": "SUITE 100",
            "city": "CARROLLTON,",
            "state": "TX",
            "postal_code": "75010",
            "telephone_number": "972-395-7630",
            "fax_number": "972-395-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 GOLDEN TRAIL COURT",
            "address_2": "SUITE 100",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75010",
            "telephone_number": "972-395-7630",
            "fax_number": "972-395-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMBROWSKI",
        "first_name": "JEFFREY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28274",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "7425",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "28274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02074250",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.