Provider Demographics
NPI:1881078285
Name:DOMINION MEDICAL SERVICES, PLLC
Entity type:Organization
Organization Name:DOMINION MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MD
Authorized Official - Prefix:MR
Authorized Official - First Name:ADEKUNLE
Authorized Official - Middle Name:ADEDAYO
Authorized Official - Last Name:ADEDEJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-601-2367
Mailing Address - Street 1:8623 N LOOP DR STE A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-4520
Mailing Address - Country:US
Mailing Address - Phone:915-881-4155
Mailing Address - Fax:915-881-4172
Practice Address - Street 1:8623 N LOOP DR STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-4520
Practice Address - Country:US
Practice Address - Phone:915-881-4155
Practice Address - Fax:915-881-4172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3416207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty