Active NPI
Martha L Gomez, D.D.S
- General Practice Dentistry
- Modesto, CA
National Provider Identifier
1013080902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 50260
- Practice address
- 1130 Coffee Rd
Suite 9a
Modesto, CA 95355-4228 - Phone
- (209) 522-8783
- Fax
- (209) 526-1470
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 50260 | CA | Primary |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 50260 | CA |
Addresses
Primary practice location
1130 Coffee Rd
Suite 9a
Modesto, CA 95355-4228
Mailing address
1130 Coffee Rd
Suite 9a
Modesto, CA 95355-4228
Phone (209) 522-8783
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50260 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chun PO Huang,DDS,Inc. | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Modesto, CA
- NPI 1700361516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236211200000",
"number": "1013080902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 COFFEE RD",
"address_2": "SUITE 9A",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554228",
"telephone_number": "209-522-8783",
"fax_number": "209-526-1470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 COFFEE RD",
"address_2": "SUITE 9A",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554228",
"telephone_number": "209-522-8783",
"fax_number": "209-526-1470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "MARTHA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2009-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "50260",
"primary": true
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "50260",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.