Miguel Angel Dominguez Martinez, SA-C

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

23-689 Issued in NM

Practice address

212 W Fiesta Dr TRLR 53a
Carlsbad, NM 88220-5523

Phone

(575) 361-8104

NPI assigned

Nov 27, 2023

Last updated

Nov 27, 2023By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1972379444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W FIESTA DR TRLR 53A",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882205523",
            "telephone_number": "575-361-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W FIESTA DR TRLR 53A",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882205523",
            "telephone_number": "575-361-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ MARTINEZ",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "NM",
            "license": "23-689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desert Sunset Management LLC
• Dialysis Clinic Inc.
• Dilip D. Madnani, M.D., LLC (Southwest ENT/ Head & Neck Surgery)
• Vy Dittrich, PHARMD
• Divine Care Medicals LLC
• Diana Donohue, LMHC
• Joshua J Dougan
• Dr Jedd Raney Pediatrics LLC
• DRS. Griffith & Griffith, LLC
• Nadine B Dubrule, MD

• Surgical Assistant in Carlsbad, NM
• Providers in Carlsbad, NM by specialty
• Surgical Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.