Dominick Carmen Adornato III, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

19351 Issued in OH

Practice address

1129 East Aurora Rd
Suite 101
Macedonia, OH 44056

Phone

(330) 468-1188

Fax

(330) 468-0464

NPI assigned

Oct 3, 2006

Last updated

Sep 13, 2012By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 8, 2020 through Jan 8, 2028

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: dadornato243043@ehrdirect.uhhospitals.org

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1306930169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 EAST AURORA RD",
            "address_2": "SUITE 101",
            "city": "MACEDONIA",
            "state": "OH",
            "postal_code": "44056",
            "telephone_number": "330-468-1188",
            "fax_number": "330-468-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 EAST AURORA RD",
            "address_2": "SUITE 101",
            "city": "MACEDONIA",
            "state": "OH",
            "postal_code": "44056",
            "telephone_number": "330-468-1188",
            "fax_number": "330-468-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADORNATO",
        "first_name": "DOMINICK",
        "middle_name": "CARMEN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "19351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000138638",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107646",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• America's Best Contacts & Eyeglasses

• Oral and Maxillofacial Surgery (Dentist) in Macedonia, OH
• Providers in Macedonia, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.