The Tooth Place, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20613 Issued in TX

Legal business name

THE TOOTH PLACE, P.A.

Practice address

2501 Paredes Line Rd Ste B3
Brownsville, TX 78526-1195

Phone

(956) 542-9200

Fax

(956) 542-9913

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Shelly S Martinez, D.D.S.NPI 1013025287

Title

Dentist

Phone

(956) 542-9200

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 1

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

• Shelly Slovak Martinez, D.D.S.

  • General Practice Dentistry
  • Brownsville, TX
  • NPI 1013025287
  NPD (past) Authorized official

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246233600000",
    "number": "1144384785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 PAREDES LINE RD STE B3",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785261195",
            "telephone_number": "956-542-9200",
            "fax_number": "956-542-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 PAREDES LINE RD STE B3",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785261195",
            "telephone_number": "956-542-9200",
            "fax_number": "956-542-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TOOTH PLACE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2009-06-29",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "956-542-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151128901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151128902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX CHIPS GROUP NUMBER",
            "identifier": "B20613-1",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172064101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Brownsville, TX
• Providers in Brownsville, TX by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.