Active NPI
Marjorie Domingo, DDS
- Pediatric Dentistry
- Garden Valley, CA
National Provider Identifier
1033401708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 43595
- Practice address
- 7220 Darling Cabin Rd
Garden Valley, CA 95633-9745 - Phone
- (805) 870-5540
- NPI assigned
- May 12, 2011
- Last updated
- May 12, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 43595 | CA | Primary |
Addresses
Primary practice location
7220 Darling Cabin Rd
Garden Valley, CA 95633-9745
Mailing address
7220 Darling Cabin Road
Garden Valley, CA 95633
Phone (805) 870-5540
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43595 | CA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305158400000",
"number": "1033401708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7220 DARLING CABIN ROAD",
"city": "GARDEN VALLEY",
"state": "CA",
"postal_code": "95633",
"telephone_number": "805-870-5540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7220 DARLING CABIN RD",
"city": "GARDEN VALLEY",
"state": "CA",
"postal_code": "956339745",
"telephone_number": "805-870-5540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGO",
"first_name": "MARJORIE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-12",
"last_updated": "2011-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "43595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.