DR. ALYSSA MARIE DOMICO DMD, MS
NPI 1871162669
Dentist - Orthodontics and Dentofacial Orthopedics in Plymouth, MN

Active since June 24, 2021
2805 CAMPUS DR STE 245, PLYMOUTH, MN 55441(763) 383-1788 Get Directions Write a Review

NPPES record last updated: July 14, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 14, 2024, Aug 30, 2023, Jun 24, 2021 (3 updates tracked since 2021).

About Dr. Alyssa Marie Domico Dmd, Ms NPPES

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

DR. ALYSSA MARIE DOMICO DMD, MS (NPI 1871162669) is an individual orthodontics and dentofacial orthopedics provider in Plymouth, Minnesota, licensed in Minnesota (D14939) and active in the NPI registry since June 2021. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1871162669
Entity TypeIndividualFemale
Primary Taxonomy1223X0400X
Provider Legal NameDR. ALYSSA MARIE DOMICOCredential: DMD, MS
Location Address2805 CAMPUS DR STE 245Plymouth, MN 55441-2678
Mailing Address2805 Campus Dr Ste 245Plymouth, MN 55441-2678 · (763) 383-1788
Sole ProprietorNo
Enumeration DateJune 24, 2021
Last NPPES UpdateJuly 14, 20243 updates tracked since enumeration
NPPES CertifiedJuly 14, 2024
NPI 1871162669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
License Licensed in MN · D14939
Definition

That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.

Also ListedDentistTaxonomy 122300000X · License D14939 (MN)
2805 CAMPUS DR STE 245, Plymouth, MN 55441

Secondary Practice Locations 2

Location 17880 Main St NMaple Grove, MN 55369-7081 · Phone (763) 515-0011
Location 2675 Water St Ste 2Excelsior, MN 55331-3072 · Phone (952) 242-9200

Other Providers at the Same Location NPPES 4

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

Dentist (Pediatric Dentistry)
2805 CAMPUS DR STE 245
PLYMOUTH, MN 55441
Clinic/Center (Dental)
2805 CAMPUS DR STE 245
PLYMOUTH, MN 55441
Dentist (Pediatric Dentistry)
2805 CAMPUS DR STE 245
PLYMOUTH, MN 55441
Dentist (Pediatric Dentistry)
2805 CAMPUS DR STE 245
PLYMOUTH, MN 55441

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 Alyssa Domico's NPI number?

The NPI number for Alyssa Domico is 1871162669. It was assigned to this individual provider in the NPPES registry on June 24, 2021.

Where is Alyssa Domico located?

Alyssa Domico practices at 2805 Campus Dr Ste 245, Plymouth, MN 55441. The listed phone number is (763) 383-1788.

What is Alyssa Domico's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.

When was this NPI record last updated?

The NPPES record for Alyssa Domico was last updated on July 14, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.