Jose Dumergue Dominguez, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 13058 Issued in FL

Practice address

3 SW 129TH Ave
Suite 210
Pembroke Pines, FL 33027-1775

Phone

(954) 450-6447

Fax

(954) 450-6270

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Networks

• Freedom Health HMO Network

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.

• Jose D Dominguez DDS PA

  • Dentist
  • Pembroke Pines, FL
  • NPI 1811310980
  NPD (past) Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1992838304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8123 NW 161ST TER",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330166659",
            "telephone_number": "305-308-7458",
            "fax_number": "954-450-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SW 129TH AVE",
            "address_2": "SUITE 210",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271775",
            "telephone_number": "954-450-6447",
            "fax_number": "954-450-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "JOSE",
        "middle_name": "DUMERGUE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 13058",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 13058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DN 13058",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea M Dolinish
• Lisset Domenech
• Pedro Enrique Dominguez Santana
• Ayme Dominguez
• Ivan Dominguez, M.D
• Clafdia Nathalie Dominique
• Meryl Donaldson
• Adrienne Emily Donawa
• Jean Donne
• Lisa Anne Donner, CHIROPRACTOR

• General Practice Dentistry in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.