Martha E. Diaz D.D.S., P.C.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

MARTHA E. DIAZ D.D.S., P.C.

Practice address

2634 Grand Ave
Suite 207
Waukegan, IL 60085-2458

Phone

(847) 599-3855

Fax

(847) 599-3859

NPI assigned

Mar 20, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eugenio Sierra, MBA

Title

Administrator

Phone

(847) 599-3855

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Martha E Diaz, DDS

  • General Practice Dentistry
  • Waukegan, IL
  • NPI 1114139540
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1043481765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2634 GRAND AVE",
            "address_2": "SUITE 207",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852458",
            "telephone_number": "847-599-3855",
            "fax_number": "847-599-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 GRAND AVE",
            "address_2": "SUITE 207",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852458",
            "telephone_number": "847-599-3855",
            "fax_number": "847-599-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA E. DIAZ D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "SIERRA",
        "authorized_official_first_name": "EUGENIO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-599-3855",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Marrero
• Alyson Genell Marsalis, LCPC
• Britney Marsh
• Annette Kathleen Marshall, SLP
• Laura Marsolais
• Daniel Martin, LSW
• Kaitlynn Elizabeth Martin
• Timothy Collier Martin
• Maria Martinez Munoz
• Adela S Martinez, RN

• Preferred Provider Organization in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Preferred Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.