Cori Jeanel Dominguez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD4695 Issued in NM

Practice address

3740 Coors Blvd NW Ste a
Albuquerque, NM 87120-4762

Phone

(505) 836-1280

NPI assigned

Jun 12, 2017

Last updated

Jun 12, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• North Coors Dental

  • Dentist
  • Albuquerque, NM
  • NPI 1215952189
  NPD (past)

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1508396698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13601 WENONAH AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871234187",
            "telephone_number": "505-205-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 COORS BLVD NW STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871204762",
            "telephone_number": "505-836-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "CORI",
        "middle_name": "JEANEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Dominguez
• Alondra Dominguez, MPH, CHW
• Ana Dominguez
• Andrea Dominguez
• Christopher Max Dominguez
• David C. Dominguez, M.D.
• Eusabio Dominguez
• Jade Dominguez
• Janet E Dominguez, C-FNP
• Karen Dominguez, PHARMD

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.