Deborah Kay Domen, R.D.H.
Dental Hygienist in Jacksonville, FL. Individual provider (NPI-1).
NPI number1750196176
StatusActive
Last updated in NPPESFeb 12, 2025
Details
- NPI
- 1750196176
- Entity type
- Individual (NPI-1)
- Name
- Ms. Deborah Kay Domen
- Credential
- R.D.H.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 12, 2025
- Certification date
- Feb 12, 2025
- Last updated
- Feb 12, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | DH31087 | FL | Yes |
| 124Q00000X | Dental Hygienist | DH043616 | GA | |
| 124Q00000X | Dental Hygienist | 9243 | NC |
Other names
- Deborah Kay Dishmond (Former Name)
Practice location
Naval Hospital 2080 Child St Dept 5000Jacksonville, FL 32214-0001
Phone 912-573-4212
Mailing address
97182 Harbor Concourse CirFernandina Beach, FL 32034-3873
Phone 910-526-2333
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