Pushpa N. Domadia, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS021004-L Issued in PA

Practice address

128 E Allegheny Ave.
Philadelphia, PA 19134-2207

Phone

(215) 634-4647

Fax

(215) 634-4647

NPI assigned

Oct 19, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902895196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342207",
            "telephone_number": "215-634-4647",
            "fax_number": "215-634-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E ALLEGHENY AVE.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342207",
            "telephone_number": "215-634-4647",
            "fax_number": "215-634-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMADIA",
        "first_name": "PUSHPA",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS021004-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0990660",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA BLUE SHIELD",
            "identifier": "DO/460384",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dolove Doulas Company
• Jennifer Dolphin, PHARMD
• Kathryn Dolphin, CRNA
• Trisha A Dolsky, CRNA
• Michelle L Dolt, CRNP
• Dayna Marie Dombrowsky, DNP, CRNA
• Susan M Domchek, MD
• Emneris Domenech, LBS
• Louis Domenico Jr., MD
• Gary F Domeracki, MD

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.