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Active NPI 1164636270 Individual Practitioner Male Practitioner

Dr. Otto Raul Alonzo Dominguez , DDS

Dentist - General Practice • Clovis, CA

Professional Overview & Biography Verified Profile Summary

Dr. Otto Alonzo Dominguez, DDS is a registered healthcare professional specializing in Dentist - General Practice in Clovis, CA. Practice services are available at 145 SHAW AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

145 Shaw Ave
Suite B1-B2

Clovis, CA 936123841

Telephone 5593252175
Fax 5593252175
Associated Practice Facility / Clinic
🏢 Otto R. Alonzo, D.d.s., Inc. Facility NPI 1639443575

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Clovis, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
36 Specialists

Practicing in Clovis, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 50719

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Kevin Brogan , MPT ATC

Physical Therapist

NPI 1245338094

MPTATC

Kevin Hughes , PT

Physical Therapist

NPI 1376641118

Physical Therapist

Theodore Mello

Physical Therapist

NPI 1861737629

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
NPI Profile Active March 21, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location March 21, 2017

Registered at 145 SHAW AVE, SUITE B1-B2, CLOVIS, CA 936123841 (Tel: 5593252175)

📍
Updated Business Mailing Address March 21, 2017

Registered at 145 SHAW AVE, SUITE B1-B2, CLOVIS, CA 936123841 (Tel: 5593252175)

👤
Provider Name / Credentials Updated March 21, 2017

Recorded as OTTO ALONZO DOMINGUEZ, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 21, 2017

Dentist (License #50719 in CA)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 145 SHAW AVE, SUITE B1-B2, CLOVIS, CA 936123841 (Tel: 5593252175)

📍
Updated Business Mailing Address July 08, 2007

Registered at 145 SHAW AVE, SUITE B1-B2, CLOVIS, CA 936123841 (Tel: 5593252175)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as OTTO ALONZO, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #50719 in CA)

🟢
Initial NPI Registration & Enumeration May 09, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164636270
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 09, 2007
Last Update: March 21, 2017
Sole Proprietor: Yes

Mailing Address

145 Shaw Ave, Suite B1-B2

Clovis, CA 936123841

Phone: 5593252175

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.