Nicolex LLC Dba Moon Valley Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

License

AZ1210 Issued in AZ

Legal business name

NICOLEX LLC DBA MOON VALLEY EYECARE

Practice address

14435 N 7TH St Ste 104
Phoenix, AZ 85022-4378

Phone

(602) 993-2727

NPI assigned

Feb 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jesse Dominguez, O.D.NPI 1669789814

Title

Owner

Phone

(602) 993-2727

Specialties & licenses 1

Addresses

Tax ID family

Moon Valley Eyecare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nicolex LLC

  • Optometrist
  • Phoenix, AZ
  • NPI 1003221185
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesse Vincent Dominguez, O.D.

  • Optometrist
  • Somerton, AZ
  • NPI 1669789814
  NPD (past) Authorized official

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1225429673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14435 N 7TH ST STE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850224378",
            "telephone_number": "602-993-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14435 N 7TH ST STE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850224378",
            "telephone_number": "602-993-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLEX LLC DBA MOON VALLEY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-06",
        "last_updated": "2015-02-06",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-993-2727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "AZ1210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lea Nickolas, FNP-BC
• Noelle M Nicolas, SLP
• Kyrie Jae Nicolds, PA-C
• Nicole Lazorwitz PSYD LLC
• Nicolex LLC
• Brigham Nicoll
• Caleb Glen Nicoll, OTR/L
• Kevin Nicoll, MD
• Angie Nicolucci
• Heidi Marie Nida-Huff, FNP-C

• Optometrist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.