Active NPI
Nicole Elisa Martinez, RDH
- Dental Hygienist
- Detroit, MI
National Provider Identifier
1255169355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2902014663
- Practice address
- 5555 Conner St
Detroit, MI 48213-3448 - Phone
- (313) 571-2648
- NPI assigned
- Jul 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2902014663 | MI | Primary |
Addresses
Primary practice location
5555 Conner St
Detroit, MI 48213-3448
Mailing address
15666 Englewood Ave
Allen Park, MI 48101-1766
Phone (313) 971-6434
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2902014663 | MI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1255169355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15666 ENGLEWOOD AVE",
"city": "ALLEN PARK",
"state": "MI",
"postal_code": "481011766",
"telephone_number": "313-971-6434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 CONNER ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482133448",
"telephone_number": "313-571-2648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "NICOLE",
"middle_name": "ELISA",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-22",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MI",
"license": "2902014663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.