JOHN M DOMANICO D.D.S. P.C. NPI 1508262544

NPI Information

  • NPI: 1508262544
  • Provider Name: JOHN M DOMANICO, D.D.S., P.C.
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 30 N MICHIGAN AVE
    SUITE522
    CHICAGO, IL
    ZIP 60602
  • Phone: (312) 629-3530

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NPI Details

JOHN M DOMANICO, D.D.S., P.C. is an oral and maxillofacial surgery dentist in Chicago, IL. The provider is an oral and maxillofacial surgery dentist specialized in 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. JOHN M DOMANICO, D.D.S., P.C. NPI is 1508262544. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

30 N MICHIGAN AVE
SUITE522
CHICAGO, IL
ZIP 60602-402
Phone: (312) 629-3530
Fax: (312) 629-3516

The provider's authorized official is John M Domanico .
The authorized official title is Owner and has the following contact phone number (312) 629-3530.

The enumeration date for this NPI number is 11/18/2014 and was last updated on 11/18/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11295840304OTHERILLINOISNPPES.CMS.HHS.GOV
21962500348OTHERILLINOISNPPES.CMS.HHS.GOV

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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