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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

DR. KERUSSO POOLEY DOMINGUEZ DDS
NPI 1841122462
Dentist - General Practice in Greensboro, NC

Active since May 29, 2026
4215 W WENDOVER AVE, GREENSBORO, NC 27407(336) 569-8669 Get Directions Write a Review

NPPES record added: June 29, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Kerusso Pooley Dominguez Dds NPPES

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

DR. KERUSSO POOLEY DOMINGUEZ DDS (NPI 1841122462) is an individual general practice provider in Greensboro, North Carolina, licensed in North Carolina (14826) and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1841122462
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. KERUSSO POOLEY DOMINGUEZCredential: DDS
Location Address4215 W WENDOVER AVEGreensboro, NC 27407-1921
Mailing Address4215 W Wendover AveGreensboro, NC 27407-1921 · (336) 569-8669
Phone(336) 569-8669
Sole ProprietorNo
Enumeration DateMay 29, 2026
Last NPPES UpdateJune 29, 2026
NPPES CertifiedJune 29, 2026
✔ NPI 1841122462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NC · 14826
Definition
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.
4215 W WENDOVER AVE, Greensboro, NC 27407
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Other Providers at the Same Location NPPES 3

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

DR. COLTEN LOUIS BUTLER DMD
Dentist
4215 W WENDOVER AVE
GREENSBORO, NC 27407
Guilford County (336) 294-5020
COLTEN BUTLER DMD PLLC
Clinic/Center (Dental)
4215 W WENDOVER AVE
GREENSBORO, NC 27407
Guilford County (336) 294-5020
DR. MCCLARY & ASSOC. WENDOVER, P.A.
Dentist (General Practice)
4215 W WENDOVER AVE
GREENSBORO, NC 27407
Guilford County (336) 294-5020

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 Kerusso Dominguez's NPI number?

The NPI number for Kerusso Dominguez is 1841122462. It was assigned to this individual provider in the NPPES registry on May 29, 2026.

Where is Kerusso Dominguez located?

Kerusso Dominguez practices at 4215 W Wendover Ave, Greensboro, NC 27407. The listed phone number is (336) 569-8669.

What is Kerusso Dominguez's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Kerusso Dominguez was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 55 days 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.