Individual provider Active NPI

Ana Raquel Martinez, DDS

  • Dentist
  • Carpinteria, CA
National Provider Identifier
1184812430
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60872 Issued in CA
Practice address
1090 Eugenia PL Ste 100
Carpinteria, CA 93013-2011
Phone
(805) 617-0686
Fax
(805) 617-0612
NPI assigned
Oct 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE00010966 WA
Dentist 122300000X 60872 CA Primary

Addresses

Primary practice location

1090 Eugenia PL Ste 100
Carpinteria, CA 93013-2011

Mailing address

1090 Eugenia PL Ste 100
Carpinteria, CA 93013-2011
Phone (805) 617-0686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20160516000330 CA Order and Referring Only - DentistPractitioner - Dentist 4385933308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00010966WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1184812430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 EUGENIA PL STE 100",
            "city": "CARPINTERIA",
            "state": "CA",
            "postal_code": "930132011",
            "telephone_number": "805-617-0686",
            "fax_number": "805-617-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 EUGENIA PL STE 100",
            "city": "CARPINTERIA",
            "state": "CA",
            "postal_code": "930132011",
            "telephone_number": "805-617-0686",
            "fax_number": "805-617-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ANA",
        "middle_name": "RAQUEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2024-04-10",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010966",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carpinteria, CA

Sources for this page

Verify at the official NPI Registry.