Antonio Dominovic, R.T.(R)(CT)(ARRT)

Primary specialty

Radiography Radiologic TechnologistTaxonomy code 2471C3402X

License

917283 Issued in OR

Practice address

17744 NE San Rafael St
Portland, OR 97230-5927

Phone

(800) 638-3240

NPI assigned

Jun 28, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1922730803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 SE 144TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972362709",
            "telephone_number": "503-515-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17744 NE SAN RAFAEL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305927",
            "telephone_number": "800-638-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINOVIC",
        "first_name": "ANTONIO",
        "credential": "R.T.(R)(CT)(ARRT)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "WA",
            "license": "60899550",
            "primary": false
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "OR",
            "license": "917283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flora Dominguez Zarate, THW DOULA
• Roman Dominguez-Soto
• Joanne Elizabeth Dominguez
• Sarah Anne Dominguez
• Christopher Anthony Dominic, DC
• Mary Ann Penny Domm, D.C.
• Diana Domnitei, MD
• Jordyn Domogalla
• Yolanda Clara Domond, M.D.
• Wendy Osorio Domreis, PNP

• Radiography Radiologic Technologist in Portland, OR
• Providers in Portland, OR by specialty
• Radiography Radiologic Technologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.