Individual provider Active NPI

Efren Martinez, D.D.S.

  • Dentist
  • Lakewood, CO
National Provider Identifier
1073780672
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
CO105802 Issued in CO
Practice address
1200 S Wadsworth Blvd Ste 105
Lakewood, CO 80232-5434
Phone
(303) 733-7533
Fax
(303) 733-9826
NPI assigned
May 13, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X CO105802 CO Primary

Addresses

Primary practice location

1200 S Wadsworth Blvd Ste 105
Lakewood, CO 80232-5434

Mailing address

1200 S Wadsworth Blvd Ste 105
Lakewood, CO 80232-5434
Phone (303) 733-7533

Other identifiers 1

IdentifierTypeStateIssuer
02058022MedicaidCO

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

LicenseStateTypeSpecialty
CO105802COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1073780672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S WADSWORTH BLVD STE 105",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802325434",
            "telephone_number": "303-733-7533",
            "fax_number": "303-733-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S WADSWORTH BLVD STE 105",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802325434",
            "telephone_number": "303-733-7533",
            "fax_number": "303-733-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "EFREN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "CO105802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02058022",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.