Individual provider Active NPI

Zoraida Sofia Dominguez

  • Attendant Care Provider
  • Las Vegas, NV
National Provider Identifier
1982104154
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
License
1704551333 Issued in NV
Practice address
1951 Stella Lake St Ste 36
Las Vegas, NV 89106-2144
Phone
(702) 595-1415
NPI assigned
Feb 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X 1704551333 NV Primary

Addresses

Primary practice location

1951 Stella Lake St Ste 36
Las Vegas, NV 89106-2144

Mailing address

652 Maccabe Ave
Las Vegas, NV 89123-6234
Phone (702) 861-7991

Other identifiers 1

IdentifierTypeStateIssuer
1704551333MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1704551333NVMDAttendant Care Provider

NPI Registry JSON

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1982104154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 MACCABE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891236234",
            "telephone_number": "702-861-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 STELLA LAKE ST STE 36",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062144",
            "telephone_number": "702-595-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "ZORAIDA",
        "middle_name": "SOFIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-14",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NV",
            "license": "1704551333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1704551333",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; 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.