NPIMap

Organization Active NPI

Saginaw Periodontal Specialist,PLLC

  • Periodontics
  • Saginaw, MI
National Provider Identifier
1376714899
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
015286 Issued in MI
Legal business name
SAGINAW PERIODONTAL SPECIALIST,PLLC
Practice address
4291 State St
Saginaw, MI 48603-4051
Phone
(989) 793-7241
NPI assigned
Mar 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Authorized official

Name
Dr. Buena L Dominguez, D.M.D.,M.S.
Title
Owner
Phone
(989) 793-7241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 015286 MI Primary

Addresses

Primary practice location

4291 State St
Saginaw, MI 48603-4051

Mailing address

4291 State St
Saginaw, MI 48603-4051
Phone (989) 793-7241

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1376714899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4291 STATE ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486034051",
            "telephone_number": "989-793-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4291 STATE ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486034051",
            "telephone_number": "989-793-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGINAW PERIODONTAL SPECIALIST,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "BUENA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-793-7241",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D.,M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "015286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.