Active NPI
Dominic W Cheung, PHARMD
- Pharmacist
- Salt Lake City, UT
National Provider Identifier
1487226536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20996-40
- Practice address
- 500 Foothill Blvd
Salt Lake City, UT 84148-7211 - Phone
- (801) 582-1565
- NPI assigned
- Jul 16, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20996-40 | WI | Primary |
Addresses
Primary practice location
500 Foothill Blvd
Salt Lake City, UT 84148-7211
Mailing address
220 S Washington St
Lake City, MN 55041-1036
Phone (507) 413-2992
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20996-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657843200000",
"number": "1487226536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 S WASHINGTON ST",
"city": "LAKE CITY",
"state": "MN",
"postal_code": "550411036",
"telephone_number": "507-413-2992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 FOOTHILL BLVD",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841487211",
"telephone_number": "801-582-1565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEUNG",
"first_name": "DOMINIC",
"middle_name": "W",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-16",
"last_updated": "2022-07-15",
"certification_date": "2022-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "20996-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.