Provider Demographics
NPI:1851557532
Name:DOMINICIS, LUIS RAMIRO JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:RAMIRO
Last Name:DOMINICIS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 FLORENCE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3937
Mailing Address - Country:US
Mailing Address - Phone:562-861-8807
Mailing Address - Fax:
Practice Address - Street 1:10418 VALLEY BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3600
Practice Address - Country:US
Practice Address - Phone:626-453-8466
Practice Address - Fax:626-453-8465
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS572461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice