Dianel Tandaguen Domingo, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11403 Issued in NC

Practice address

2675 Court Dr
Gastonia, NC 28054-1478

Phone

(704) 824-7800

NPI assigned

Mar 27, 2008

Last updated

Oct 4, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1508038761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541478",
            "telephone_number": "704-824-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541478",
            "telephone_number": "704-824-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "DIANEL",
        "middle_name": "TANDAGUEN",
        "name_prefix": "Miss",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "11403",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "3167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Patrice Dodge, PH.D.
• Jacobus Viggo Dodoo, M. PHARM
• Josephine Henry Dogan, BSW
• Brittany Doherty, MS, CCC-SLP
• Robert M. Doline, M.D.
• Ryan Kaylianna Donelson, BCBA, LBA
• William T Donigan, DDS
• Mona Louise Dooley, M.A., LPC
• Saskia Dorgeloh, LCSWA
• Dorothys Daughter LLC

• Physical Therapist in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.