1. Home
  2. Directory
  3. Illinois
  4. Richmond
  5. Dentist
  6. NPI Profile

DR. DAVID DWIGHT DOMENELLA DDS
NPI 1427217918
Dentist in Richmond, IL

Active since June 09, 2008PECOS Enrolled
9716 US HIGHWAY 12, RICHMOND, IL 60071(815) 678-2800(815) 678-4807 Get Directions Write a Review

NPPES record last updated: October 11, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. David Dwight Domenella Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DAVID DWIGHT DOMENELLA DDS (NPI 1427217918) is an individual dentist in Richmond, Illinois, licensed in Illinois (019.019680) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1427217918
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. DAVID DWIGHT DOMENELLACredential: DDS
Location Address9716 US HIGHWAY 12Richmond, IL 60071-9253
Mailing Address9716 Us Highway 12Richmond, IL 60071-9253 · (815) 678-2800 · Fax (815) 678-4807
Phone(815) 678-2800
Fax(815) 678-4807
Sole ProprietorYes
Enumeration DateJune 9, 2008
Last NPPES UpdateOctober 11, 2012
✔ NPI 1427217918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IL · 019.019680
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
9716 US HIGHWAY 12, Richmond, IL 60071
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. David Dwight Domenella Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60071 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MAKING CONNECTIONS
Clinic/Center (Mental Health (Including Community Mental Health Center))
9716 US HIGHWAY 12
RICHMOND, IL 60071
McHenry County (262) 208-0078
LARISSA MARIE DIDRIKSEN LCSW
Social Worker (Clinical)
9716 US HIGHWAY 12
RICHMOND, IL 60071
McHenry County (815) 581-8131

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is David Domenella's NPI number?

The NPI number for David Domenella is 1427217918. It was assigned to this individual provider in the NPPES registry on June 9, 2008.

Where is David Domenella located?

David Domenella practices at 9716 Us Highway 12, Richmond, IL 60071. The listed phone number is (815) 678-2800.

What is David Domenella's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is David Domenella enrolled in Medicare?

Yes. David Domenella is registered in the Medicare PECOS enrollment system.

What insurance does David Domenella accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Anthem Blue Cross and Blue Shield and BEST Life and 7 other insurers list David Domenella as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for David Domenella was last updated on October 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.