1. Home
  2. Directory
  3. Michigan
  4. Grand Rapids
  5. Dentist
  6. NPI Profile

JAMES MARK DOMIN D.D.S.
NPI 1891880654
Dentist - Oral and Maxillofacial Surgery in Grand Rapids, MI

Active since October 04, 2006PECOS Enrolled
2140 LAKE MICHIGAN DR NW, GRAND RAPIDS, MI 49504(616) 735-2870(616) 735-2871 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About James Mark Domin D.d.s. NPPES

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

JAMES MARK DOMIN D.D.S. (NPI 1891880654) is an individual oral and maxillofacial surgery provider in Grand Rapids, Michigan, licensed in Michigan (2901016850) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891880654
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameJAMES MARK DOMINCredential: D.D.S.
Location Address2140 LAKE MICHIGAN DR NWGrand Rapids, MI 49504-4785
Mailing Address847 Parchment Dr Se, Suite 125Grand Rapids, MI 49546-2303 · (616) 735-2870 · Fax (616) 735-2871
Phone(616) 735-2870
Fax(616) 735-2871
Sole ProprietorNo
Enumeration DateOctober 4, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1891880654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in MI · 2901016850
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
2140 LAKE MICHIGAN DR NW, Grand Rapids, MI 49504
Open in Google Maps ↗

Other Identifiers 4

Other168500MI · Bcbsd
Medicare UPINU65862MI
Medicare ID-Type UnspecifiedCC0861 P00019509MI · Railroad Medicare
Other0D111530MI · Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana 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)

James Mark Domin D.d.s. 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 49504 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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 6

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

PAUL JEFFREY BROOKS D.D.S.
Dentist (Oral and Maxillofacial Surgery)
2140 LAKE MICHIGAN DR NW
GRAND RAPIDS, MI 49504
Kent County (616) 735-2870
STEVEN W SCHULTZ D.D.S.
Dentist (Oral and Maxillofacial Surgery)
2140 LAKE MICHIGAN DR NW
GRAND RAPIDS, MI 49504
Kent County (616) 735-2870
ORAL & MAXILLOFACIAL SURGERY ASSOCIATES OF WESTERN MICHIGAN PLC
Oral & Maxillofacial Surgery
2140 LAKE MICHIGAN DR NW
GRAND RAPIDS, MI 49504
Kent County (616) 791-9600
BRANT A ERBENTRAUT D.D.S.
Dentist (Oral and Maxillofacial Surgery)
2140 LAKE MICHIGAN DR NW
GRAND RAPIDS, MI 49504
Kent County (616) 735-2870
LONNY E ZIETZ D.D.S., M.S.
Dentist (Oral and Maxillofacial Surgery)
2140 LAKE MICHIGAN DR NW
GRAND RAPIDS, MI 49504
Kent County (616) 791-9600
DR. VICTOR H MASTAGLIO DDS
Dentist
2140 LAKE MICHIGAN DR NW
GRAND RAPIDS, MI 49504
Kent County (616) 735-2577

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 James Domin's NPI number?

The NPI number for James Domin is 1891880654. It was assigned to this individual provider in the NPPES registry on October 4, 2006.

Where is James Domin located?

James Domin practices at 2140 Lake Michigan Dr NW, Grand Rapids, MI 49504. The listed phone number is (616) 735-2870.

What is James Domin's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is James Domin enrolled in Medicare?

Yes. James Domin is registered in the Medicare PECOS enrollment system.

What insurance does James Domin accept?

Health plans from BEST Life, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 9 other insurers list James Domin 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 James Domin was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.