Active NPI
Kelsey Lynn Martinez
- General Practice Dentistry
- Cincinnati, OH
National Provider Identifier
1003444241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 35.026388
- Practice address
- 3333 Burnet Ave
Cincinnati, OH 45229-3039 - Phone
- (452) 293-0395
- NPI assigned
- Apr 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 35.026388 | OH | Primary |
Addresses
Primary practice location
3333 Burnet Ave
Cincinnati, OH 45229-3039
Mailing address
3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 803-5601
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.026388 | OH | MD | General Practice Dentistry |
Networks
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
- devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1003444241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 BURNET AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293026",
"telephone_number": "513-803-5601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 BURNET AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293039",
"telephone_number": "452-293-0395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "KELSEY",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-01",
"last_updated": "2021-06-09",
"certification_date": "2021-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "35.026388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.