Active NPI
Buena Dominguez, DMD,MS
- Periodontics
- Saginaw, MI
National Provider Identifier
1508833229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 015286
- Practice address
- 4291 State St
Saginaw, MI 48603-4051 - Phone
- (989) 793-7241
- Fax
- (989) 793-0254
- NPI assigned
- Mar 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 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
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015286 | MI | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Periodontal Specialists of Clarkston | Periodontics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Periodontics
- Clarkston, MI
- NPI 1548447576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508833229",
"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",
"fax_number": "989-793-0254"
},
{
"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",
"fax_number": "989-793-0254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "BUENA",
"name_prefix": "Dr.",
"credential": "DMD,MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.