Dominick Alexander Maldonado, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DDS109866 Issued in CA

Practice address

892 W Beverly Blvd
Montebello, CA 90640-4213

Phone

(323) 313-1070

NPI assigned

Feb 19, 2024

Sex

Male

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 CA

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

Locations

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.

• Karim Zaklama, D.D.S., Inc.

  dba Montebello Smiles Dentistry

  • General Practice Dentistry
  • Montebello, CA
  • NPI 1063135713
  NPD

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1841055910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5619 E JOAQUIN CT",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "892 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906404213",
            "telephone_number": "323-313-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "DOMINICK",
        "middle_name": "ALEXANDER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS109866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberto Madrid, MD
• Iris Magallanes
• Carlos Garcia Makabali, M.D.
• Ardavan Makaremi, PT, DPT
• Hamid Malakooti, M.D.
• Edward Maldonado
• Charlton Mallari, PT, DPT, CSCS
• Emmanuel Manalo, PT
• Prabhat S Manchanda, MD
• Benjamin Mandel, M.D

• Dentist in Montebello, CA
• Providers in Montebello, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.