Marvin Ryan Domondon, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8341 Issued in NC

Practice address

201 Providence Rd
Charlotte, NC 28207-1417

Phone

(704) 376-6470

Fax

(704) 496-2914

NPI assigned

May 3, 2007

Last updated

Dec 31, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Practice roles

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.

• Armstrong & Eshleman, PA

  • General Practice Dentistry
  • Charlotte, NC
  • NPI 1083741565
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262217600000",
    "number": "1154543858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PROVIDENCE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071417",
            "telephone_number": "704-376-6470",
            "fax_number": "704-496-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PROVIDENCE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071417",
            "telephone_number": "704-376-6470",
            "fax_number": "704-496-2914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMONDON",
        "first_name": "MARVIN",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2009-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Robert Dombrowsky, MD
• Akosua B. Domfeh, M.D.
• Madison Ayers Domico, DPT
• Kenia Dominguez Navarrete, PA-C
• Dominion Health Family Wellness Center
• Maya Domoto, LPC
• Don G. Timpton, D.D.S. & Associates, PA (Carmel Commons Dental)
• Donaco Medical Supply, LLC (HR HealthCare Patient Services)
• Alexandra Beery Donahue, PA-C
• Donald D. Fraser, M.D., P.a.

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; 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.