JOHN M DOMANICO, D.D.S., P.C. (NPI# 1508262544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508262544 |
| Entity Type | Organization |
| Organization Name | JOHN M DOMANICO, D.D.S., P.C. |
| Practice Address |
30 N Michigan Ave Suite522 Chicago IL 60602-3402 |
| Practice Telephone | 3126293530 |
| Practice Fax Number | 3126293516 |
| Mailing Telephone | 3126293530 |
| Mailing Fax Number | 3126293516 |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |
| Authorized Official Name | DR. JOHN M DOMANICO (OWNER) |
| Authorized Official Telephone | 3126293530 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | NPPES.CMS.HHS.GOV | 1295840304 | 01 |
| IL | NPPES.CMS.HHS.GOV | 1962500348 | 01 |
| Street Address |
30 N MICHIGAN AVE SUITE522 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60602-3402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629070743 | Kenneth A Krebs | Dentist | 30 N Michigan Ave, Ste 822, Chicago, IL 60602-3805 | 2005-06-01 |
| 1659985661 | Saint Anthony Health Affiliates | Clinic/Center | 30 N Michigan Ave, Chicago, IL 60602-3402 | 2020-09-08 |
| 1447876099 | Shawnte F Bennett | Marriage & Family Therapist | 30 N Michigan Ave, Chicago, IL 60602-3402 | 2020-06-19 |
| 1871112417 | Vulnus & Cura Psychotherapy LLC | Psychologist | 30 N Michigan Ave, Chicago, IL 60602-3402 | 2020-04-14 |
| 1962034579 | Joey Rea | Psychologist | 30 N Michigan Ave, Chicago, IL 60602-3402 | 2020-02-11 |
| 1649824558 | Rachel Casey | Marriage & Family Therapist | 30 N Michigan Ave, Chicago, IL 60602-3402 | 2019-07-29 |
| 1316437809 | Aimee Dokko Osborne | Counselor | 30 N Michigan Ave, Chicago, IL 60602-3402 | 2018-05-10 |
| 1396257366 | Elizabeth Ashley Aram | Psychologist | 30 N Michigan Ave, Chicago, IL 60602-3402 | 2017-10-31 |
| 1396279287 | Marlene Cervantes | Social Worker | 30 N Michigan Ave, Chicago, IL 60602-3402 | 2017-04-18 |
| 1528508744 | Darlene Perry | Psychologist | 30 N Michigan Ave, Chicago, IL 60602-3402 | 2017-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710539705 | Biyang Wang | Social Worker | 9 W Washington St, Chicago, IL 60602 | 2019-07-10 |
| 1538724349 | Megan Asta Sarasek | Social Worker | 134 N Lasalle Street, Suite 400, Chicago, IL 60602 | 2019-05-07 |
| 1659850691 | Sara Chen | Dentist | 105 West Madison, 3rd Floor, Chicago, IL 60602 | 2018-08-10 |
| 1942795059 | Pratiti Rajeshkumar Gandhi | Dentist | 33 N Dearborn St Ste 2400, Chicago, IL 60602 | 2018-06-30 |
| 1154833994 | Ywca Metropolitan Chicago | Counselor | 1 North Lasalle Street, Suite 1150, Chicago, IL 60602 | 2017-11-02 |
| 1013434620 | Michelle Malters | Counselor | 30 N Michigan Ave Ste 1909, Chicago, IL 60602 | 2017-08-24 |
| 1740729474 | Jd Manikowski, D.d.s., LLC | Health Maintenance Organization | 30 N. Michigan Ave #1520, Chicago, IL 60602 | 2017-02-14 |
| 1568909943 | Pratiksha Agrawal | Dentist | 105 W Madison St Fl 3, Chicago, IL 60602 | 2017-01-24 |
| 1790221521 | Anastasia Scangas | Social Worker | 30 N Michigan Ave Ste 826, Chicago, IL 60602 | 2017-01-18 |
| 1194269837 | Jenna Peterson | Psychologist | 111 N Wabash Ave Ste 822, Chicago, IL 60602 | 2016-12-15 |
| Find all providers in zip 60602 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255986576 | Othman Rezki | Dentist | 1900 W Polk St # 611, Chicago, IL 60612-3723 | 2019-08-04 |
| 1790146132 | Family Millennium Dentistry, Inc. | Dentist | 1342 W Randolph St, Chicago, IL 60607-1522 | 2016-03-13 |
| 1962769422 | Dr. Sunil Sinha and Associates Inc. | Dentist | 850 South Wabash Avenue, Suite 310, Chicago, IL 60605 | 2012-04-20 |
| 1669746418 | Biraj M. Shah | Dentist | 1900 W Polk St Ste 612, Chicago, IL 60612 | 2012-02-25 |
| 1417248261 | Jordan Ray Ledger | Dentist | 1229 W Washington Blvd, Suite 220, Chicago, IL 60607-2132 | 2011-04-27 |
| 1336377456 | Jason Sean Schrotenboer | Dentist | 3927 W Belmont Ave Ste 101, Chicago, IL 60618-5170 | 2009-06-26 |
| 1326293226 | Richard J Bret | Dentist | 7100 W. Higgins, Chicago, IL 60656 | 2008-11-20 |
| 1467607556 | Ora Studios | Dentist | 1827 S Michigan Ave, Chicago, IL 60616-1601 | 2008-11-18 |
| 1831342377 | Raza Ali Hussain | Dentist | 1025 W Monroe St Unit 3w, Chicago, IL 60607-2745 | 2008-10-28 |
| 1760679294 | Armitage Oral Surgery | Dentist | 2220 W Armitage Ave, Chicago, IL 60647-4461 | 2007-09-28 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.