Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JESSE DOMINGUEZ
Active Sole ProprietorJESSE DOMINGUEZ is a Optician healthcare provider located in FORT WAYNE, Indiana. NPI 1245198696 is currently active in the NPPES registry. Verify at CMS.
Optician · FORT WAYNE, IN
Registration Details
- NPI Number
- 1245198696
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 14, 2026 (0.60534076871873 yrs)
- Last Updated
- Jan 14, 2026
- License
-
67047515A (IN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
7970 W JEFFERSON BLVDFORT WAYNE, IN, 468044140Browse IN providers · Browse ZIP 46804
- Phone
- 2604356100
- Primary Specialty
-
Optician
156F00000X
Other Optician Providers in FORT WAYNE, IN
| Name | Credential | NPI |
|---|---|---|
| LAKISHA GRADY | — | 1114797313 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.