Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dustin Dedomenico, DMDMS

Individual provider Dentist · NPI 1902224975

Dustin Dedomenico, DMDMS is a Dentist in Tampa, Florida. Practices as a sole proprietor. Licensed in Florida and Kentucky.

Licensed in
FL, KY
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

11012 N Dale Mabry Hwy Ste 302
Tampa, FL 33618-3821
Phone: (813) 961-1414
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence DN20727 (FL)
Dentist Taxonomy 122300000X · Licence KY 9443 (KY)

Record details

NPI number1902224975
Entity typeIndividual (Type 1)
GenderMale
Credentials DMDMS
Sole proprietorYes
NPI enumeratedApril 7, 2014
Last updated in NPPESSeptember 24, 2016
Mailing address11012 N Dale Mabry Hwy Ste 302, Tampa, FL 33618-3821

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