Mr Edward Domina, DDS is a
Dentist - General Practice based in Orland Pk, Illinois. Mr Edward Domina is licensed to practice in Illinois (license number 019A15355) and his current practice location is
8651 West 159th Street, Suite 1, Orland Pk, Illinois. He can be reached at his office (for appointments etc.) via phone at
(708) 429-0900.
NPI number for Mr Edward Domina is 1639290315 and his current mailing address is 8651 West 159th Street, Suite 1, Orland Pk, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1639290315.
Healthcare Provider's Profile
Full Name | Mr Edward Domina |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 8651 West 159th Street, Orland Pk, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1639290315
- Provider Enumeration Date: 04/02/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Edward Domina such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1639290315 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 019A15355 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Edward Domina is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Edward Domina, DDS 8651 West 159th Street, Suite 1, Orland Pk, IL 60462 Ph: (708) 429-0900 | Mr Edward Domina, DDS 8651 West 159th Street, Suite 1, Orland Pk, IL 60462 Ph: (708) 429-0900 |
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