Victor Luis Dominguez, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

069548 Issued in MI

Practice address

2585 W Houghton Lake Dr
Prudenville, MI 48651-9624

Phone

(989) 366-2900

NPI assigned

Oct 6, 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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291766400000",
    "number": "1184711863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 W HOUGHTON LAKE DR",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "486519624",
            "telephone_number": "989-366-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 W HOUGHTON LAKE DR",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "486519624",
            "telephone_number": "989-366-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "VICTOR",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "069548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David L. Hanson DDS.,PC.
• Alyssa Cassidy Davies
• Nettie M Deman
• Kelly V DO
• Brigitte Diane Doehring
• Riley Joseph Dotson
• Reine Driscoll-Grammatico
• Ilamae Elizabeth Dyer
• East Bay Medical Center, P.C.
• Relicious N Eboh

• Family Medicine Physician in Prudenville, MI
• Providers in Prudenville, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; 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.