Andres Rudolfo Martinez II

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

019035232 Issued in IL

Practice address

134 N 23Rd Ave
Melrose Park, IL 60160-3635

Phone

(708) 769-2224

NPI assigned

Mar 28, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: amartinez172073@uihealth.direct-ci.com

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1124879093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N 23RD AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601603635",
            "telephone_number": "708-769-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 N 23RD AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601603635",
            "telephone_number": "708-769-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ANDRES",
        "middle_name": "RUDOLFO",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019035232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Theresa Marek, CADC
• Daniel Marsh, LPC
• Stephanie Renee Marsh, RD, LDN
• Xavier Martillo
• Paul Martin, LCPC
• Bryan Martinez
• Esther Martinez
• Jacqueline M Martinez, D.C.
• Lillian Martinez
• Anthony Joseph Martino, M.D.

• Pediatric Dentistry in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.