Ivan Alejandro Medina-Martinez, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

102012 Issued in CA

Practice address

3403 Wilson Rd
Bakersfield, CA 93309-5208

Phone

(661) 741-0310

Fax

(661) 349-9980

NPI assigned

Sep 26, 2017

Last updated

Jan 16, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ivan Medina-Martinez DDS, Inc.

  • Dental Clinic/Center
  • Bakersfield, CA
  • NPI 1467945212
  NPD Authorized official
• William Cox Dental Corporation

  dba Gentle Dental Wible

  • General Practice Dentistry
  • Bakersfield, CA
  • NPI 1992919997
  NPD (past)

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642291200000",
    "number": "1114436854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 WIBLE RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933096507",
            "telephone_number": "661-835-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3403 WILSON RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933095208",
            "telephone_number": "661-741-0310",
            "fax_number": "661-349-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA-MARTINEZ",
        "first_name": "IVAN",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-01-16",
        "certification_date": "2022-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "102012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Group of San Joaquin Valley
• Medical Network Management LLC
• Medical Support Los Angeles a Medical Corporation
• Rosaisela Medina Ordaz
• Lizbeth Medina Quiroz
• Alfred Medina, R1215080915
• Benjamin Michael Medina
• David Medina
• Edward Martin Medina
• Erica Christina Medina

• Dentist in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2022; 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.