Active NPI
Beverly K Martinsons, DDS
- General Practice Dentistry
- National City, CA
National Provider Identifier
1073616546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 48328
- Practice address
- 2 N Euclid Ave Suite #a B C
National City, CA 91950-1967 - Phone
- (619) 205-6363
- Fax
- (619) 263-4247
- NPI assigned
- Sep 7, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 48328 | CA | Primary |
Addresses
Primary practice location
2 N Euclid Ave Suite #a B C
National City, CA 91950-1967
Mailing address
4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 428-4463
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FHC70961F | Other | MEDI-CAL |
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 |
|---|---|---|---|
| 48328 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro de Salud de la Comunidad de San Ysidro Inc | 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.
-
dba San Ysidro Health Senior Dental Center
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1457033813
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073616546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4004 BEYER BLVD",
"city": "SAN YSIDRO",
"state": "CA",
"postal_code": "921732007",
"telephone_number": "619-428-4463",
"fax_number": "619-428-2625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 N EUCLID AVE SUITE #A B C",
"city": "NATIONAL CITY",
"state": "CA",
"postal_code": "919501967",
"telephone_number": "619-205-6363",
"fax_number": "619-263-4247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINSONS",
"first_name": "BEVERLY",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "48328",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "FHC70961F",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in National City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.