Individual provider Active NPI

Jorge Oscar Dominicis, DDS

  • Dentist
  • Downey, CA
National Provider Identifier
1336833698
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108489 Issued in CA
Practice address
8202 Florence Ave Ste 101
Downey, CA 90240-3937
Phone
(562) 861-8807
NPI assigned
Jun 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 108489 CA Primary

Addresses

Primary practice location

8202 Florence Ave Ste 101
Downey, CA 90240-3937

Mailing address

7660 Coolgrove Dr
Downey, CA 90240-2626
Phone (562) 367-5807

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
108489CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1336833698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7660 COOLGROVE DR",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902402626",
            "telephone_number": "562-367-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 FLORENCE AVE STE 101",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902403937",
            "telephone_number": "562-861-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINICIS",
        "first_name": "JORGE",
        "middle_name": "OSCAR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.