Donald Joseph Radomski, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

FL10133 Issued in FL

Practice address

1371 Country Club Rd
Gulf Breeze, FL 32563-3451

Phone

(850) 934-8220

Fax

(850) 932-3661

NPI assigned

Dec 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154483154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 COUNTRY CLUB RD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633451",
            "telephone_number": "850-934-8220",
            "fax_number": "850-932-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 COUNTRY CLUB RD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633451",
            "telephone_number": "850-934-8220",
            "fax_number": "850-932-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOMSKI",
        "first_name": "DONALD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "FL10133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Publix Super Markets Inc
• Publix Super Markets Inc
• Pvha/Sims - Gulf Breeze Courtyard, LLC
• Paul Anthony Quinlan, D.D.S.
• Quintin O Law MD PA
• Nageen Rak, D.D.S.
• Ramps LLC
• Katherine G Randall, LPC
• Robert Burr Randel, D.C.
• Charles Alan Ray, MS, LAT, ATC

• General Practice Dentistry in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.