Individual provider Active NPI

Martha Patricia Villalobos, DDS

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1174503171
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10701 Issued in MD
Practice address
2080 Child St
Jacksonville, FL 32214-4908
Phone
(904) 542-7837
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10701 MD Primary

Addresses

Primary practice location

2080 Child St
Jacksonville, FL 32214-4908

Mailing address

1300 Douglas Cir
Key West, FL 33040-4536
Phone (305) 293-4818

Other practice location 1

480 Central Ave
Pearl Harbor, HI 96860-4908
Phone (808) 473-1880 ext. 3390

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
10701MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1174503171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 DOUGLAS CIR",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330404536",
            "telephone_number": "305-293-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322144908",
            "telephone_number": "904-542-7837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Pearl Harbor",
            "state": "HI",
            "postal_code": "968604908",
            "country_code": "US",
            "telephone_number": "808-473-1880 x3390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLALOBOS",
        "first_name": "MARTHA",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "10701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.