Martin Dominger, DDS,MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

044538 Issued in NY

Practice address

5225 Nesconset Hwy
Suite 57
Port Jefferson Station, NY 11776-2053

Phone

(631) 474-4600

Fax

(631) 474-9056

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 17, 2026 through Jun 17, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689757668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 NESCONSET HWY",
            "address_2": "SUITE 57",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762053",
            "telephone_number": "631-474-4600",
            "fax_number": "631-474-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 NESCONSET HWY",
            "address_2": "SUITE 57",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762053",
            "telephone_number": "631-474-4600",
            "fax_number": "631-474-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGER",
        "first_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DDS,MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "044538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Digiacomo, P.A.
• Peter Dilauro, LPN
• Marina Dillon, FNP-C
• Donald Dodge
• Emily Domb
• Denise Lynne Donaldson Kaiser, MBA, MS,RD, CDN
• John Doris
• Virginia Dossantos, DMD
• Patricia Douglas
• Andrew J Dowd, MD

• Oral and Maxillofacial Surgery (Dentist) in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.