EDUARDO JOSE DOMINGUEZ (NPI# 1982195939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982195939 |
| Entity Type | Individual |
| Full Name | EDUARDO JOSE DOMINGUEZ |
| Credential | SA-C |
| Practice Address |
12011 Lee Jackson Memorial Hwy Fairfax VA 22033 |
| Mailing Address |
Po Box 221135 Chantilly VA 20153-1135 |
| Practice Telephone | 7033491379 |
| Practice Fax Number | 2147640880 |
| Mailing Telephone | 7033491379 |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2019-03-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
12-135 | WI | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457428138 | Eduardo Dominguez | Specialist/Technologist, Other | 2424 N Wyatt Dr, Tucson, AZ 85712-6115 | 2006-11-29 |
| Street Address |
12011 LEE JACKSON MEMORIAL HWY |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831171800 | Jason Mark Rashkin | Internal Medicine | 12011 Lee Jackson Memorial Hwy, Fairfax, VA 22033-3310 | 2005-11-16 |
| 1376013391 | Nan Liu | Acupuncturist | 12011 Lee Jackson Memorial Hwy, Suite #320, Fairfax, VA 22033 | 2018-12-03 |
| 1033535778 | Bnm, Inc. | Pediatrics | 12011 Lee Jackson Memorial Hwy, Suite 220, Fairfax, VA 22033-3310 | 2014-03-05 |
| 1962836072 | Rk Dental Care | Dentist | 12011 Lee Jackson Memorial Hwy, Suite 502, Fairfax, VA 22033-3310 | 2013-08-26 |
| 1932447463 | Health Connect Ipa | Internal Medicine | 12011 Lee Jackson Memorial Hwy, Suite 504, Fairfax, VA 22033-3310 | 2013-01-17 |
| 1346591989 | Komal S. Karmacharya | Dentist | 12011 Lee Jackson Memorial Hwy, Suite 502, Fairfax, VA 22033-3310 | 2012-09-23 |
| 1598044042 | Oladapo Michael Onijala | Pharmacist | 12011 Lee Jackson Memorial Hwy, Fairfax, VA 22033-3310 | 2011-08-15 |
| 1972750032 | Rahmatullah Ishaqzay | Clinic/Center | 12011 Lee Jackson Memorial Hwy, Fairfax, VA 22033-3310 | 2008-08-20 |
| 1215193529 | Constantine Tziros | Internal Medicine | 12011 Lee Jackson Memorial Hwy, Penderbrook Medical Center, Fairfax, VA 22033-3310 | 2008-08-06 |
| 1033390356 | Paramount Care Physicians | Internal Medicine | 12011 Lee Jackson Memorial Hwy, Suite 230, Fairfax, VA 22033-3310 | 2007-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| Taxonomy Code | 246ZC0007X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Assistant |
| A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. |
| Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720625080 | Jackson Ariel Moscoso | Specialist/Technologist, Other | 3127 Plantation Pkwy, Fairfax, VA 22030-2117 | 2019-12-05 |
| 1326582537 | Cardiovascular Surgical Services Inc | Specialist/Technologist, Other | 6101 Fox Run, Fairfax, VA 22030-5949 | 2016-12-06 |
| 1538602578 | Freddy Albert Torrejon | Specialist/Technologist, Other | 11224 Wilburn Dr, Fairfax, VA 22030-5557 | 2016-11-23 |
| 1033501978 | Faiaz Ahmad Nady | Specialist/Technologist, Other | 3700 Joseph Siewick Dr Ste 408-a, Fairfax, VA 22033-1744 | 2015-03-02 |
| 1225469851 | Lamarcus Davis | Specialist/Technologist, Other | 9838 Fairfax Sq, Apt 269, Fairfax, VA 22031-4235 | 2013-12-08 |
| 1427324722 | Fair Oaks Surgical Associates LLC | Specialist/Technologist, Other | 3700 Joseph Siewick Dr Ste 408, Fairfax, VA 22033-1745 | 2012-03-30 |
| 1982975249 | Ian De Vocht | Specialist/Technologist, Other | 12011 Lee Jackson Memorial Hwy Ste 501, Fairfax, VA 22033 | 2012-01-18 |
| 1649540550 | Essam A. Fawzy | Specialist/Technologist, Other | 12011 Lee Jackson Hwy Ste 501, Fairfax, VA 22033-3315 | 2012-01-09 |
| 1487252862 | Ashley Givhens | Specialist/Technologist, Other | 12011 Lee Jackson Hwy Ste 501, Fairfax, VA 22033-3315 | 2020-10-16 |
| 1891336475 | Yama Ahmadi | Specialist/Technologist, Other | 12011 Lee Jackson Memorial Hwy Ste 501, Fairfax, VA 22033-3315 | 2019-10-04 |
| Find all providers in FAIRFAX | ||||
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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.