Damien Domenech, D.D.S. – General Practice Dentistry

Key facts

NPI: 1306980800
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 21813 (MA)
Practice address: 156 Hartford Ave Unit D
Hopedale, MA 01747-1554
Phone: (508) 422-0009
NPI assigned: Feb 16, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Dental Gems P.C. Dental Clinic/Center · Hopedale, MA · NPI 1881167567

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
049521	NY	MD	Dentist

Practice roles

Organization	Specialty	Status	New patients
Dental Gems P.C.		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	049521	NY
General Practice Dentistry	1223G0001X	21813	MA	Yes

Addresses

Primary practice location

156 Hartford Ave Unit D
Hopedale, MA 01747-1554

Mailing address

20 Carl Rd
Walpole, MA 02081-1106
Phone (617) 366-6791

Other practice location 1

127 W 79th St
Suite 2
New York, NY 10024-6416
Phone (212) 580-4790

Other providers in Hopedale, MA

All providers in Hopedale, MA · General Practice Dentistry in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.