Dominique Gnatowski

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS045348 Issued in PA

Practice address

4250 Richmond St
Philadelphia, PA 19137-1928

Phone

(215) 533-2787

NPI assigned

Jun 17, 2021

Last updated

Jul 29, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1114595931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 RICHMOND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191371928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 RICHMOND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191371928",
            "telephone_number": "215-533-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GNATOWSKI",
        "first_name": "DOMINIQUE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS045348",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": "13202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgnatowski45380@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060321956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ellen Gluzman, MD
• Aaron Anthony Glynn, MB MCH FRCS(TR&ORTH)
• Frederick Gmora, D.O.
• Sabrina Gmuca, M.D.
• GMZ Home Care LLC
• Emily Gnatt, AUD
• Rachael Gnias, DPT
• Rosaleen Creedon Gnoffo, PT, MS, DPT, PCS
• Bipul Gnyawali, MD
• Go Coach Transport Inc (Go Coach Transport)

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.