IndividualActive
Jesse Dominguez
NPI 1245198696 · Technician/Technologist · Fort Wayne, IN
Provider details
- NPI number
- 1245198696
- Entity type
- Individual
- Primary specialty
- Technician/TechnologistEye and Vision Services Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 67047515A (IN)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
7970 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone: (260) 435-6100
Approximate (ZIP-level) locationGet directions
Mailing address
1131 Sinclair St
Fort Wayne, IN 46808-2647
Registry dates
- Enumerated
- 2026-01-14
- Last updated
- 2026-01-14
- Certified
- 2026-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.