Individual provider Active NPI

Juan Pedro Martinez, D D S

  • General Practice Dentistry
  • Inglewood, CA
National Provider Identifier
1235269457
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36580 Issued in CA
Practice address
1200 S Inglewood Ave
Suite # 100
Inglewood, CA 90301-8121
Phone
(310) 674-3902
Fax
(310) 674-4079
NPI assigned
Mar 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 36580 CA Primary

Addresses

Primary practice location

1200 S Inglewood Ave
Suite # 100
Inglewood, CA 90301-8121

Mailing address

1200 S Inglewood Ave
Suite # 100
Inglewood, CA 90301-8121
Phone (310) 674-3902

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
36580CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235269457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S INGLEWOOD AVE",
            "address_2": "SUITE # 100",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903018121",
            "telephone_number": "310-674-3902",
            "fax_number": "310-674-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S INGLEWOOD AVE",
            "address_2": "SUITE # 100",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903018121",
            "telephone_number": "310-674-3902",
            "fax_number": "310-674-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JUAN",
        "middle_name": "PEDRO",
        "name_prefix": "Dr.",
        "credential": "D D S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.