Amanda Lee Martinez

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12013374A Issued in IN

Practice address

520 W Navajo St
West Lafayette, IN 47906-1999

Phone

(765) 463-5437

NPI assigned

Apr 13, 2020

Last updated

Jun 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amanda Lee Zolcak Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bozic Pediatric Dentistry, P.C.

  • Pediatric Dentistry
  • Indianapolis, IN
  • NPI 1447616545
  NPD (past)
• John a. Bozc, D.D.S. PC

  • Pediatric Dentistry
  • West Lafayette, IN
  • NPI 1255843116
  NPD (past)
• Pediatric Dentistry West, LLC

  • Pediatric Dentistry
  • Indianapolis, IN
  • NPI 1366489627
  NPD (past)
• University Pediatric Dentistry Associates

  • Pediatric Dentistry
  • Indianapolis, IN
  • NPI 1003947599
  NPD (past)

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1265051999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 W NAVAJO ST",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061999",
            "telephone_number": "765-463-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W NAVAJO ST",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061999",
            "telephone_number": "765-463-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8930 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462342132",
            "country_code": "US",
            "telephone_number": "317-271-6060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12013374A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300038906",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ZOLCAK",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taylor Marlatt
• Sara Ann Marlow
• Kenneth E Marnocha, MD
• Phyllis Martin-Simmerman, MD
• Steven C Martin, MD
• Kimber Joy Martinez, LCSW
• Brenda Masiga-Crowell
• Ellen Marie Mason, BCBA
• Mackenzie Massingill, BCBA
• Julie T Massoth, NP

• Pediatric Dentistry in West Lafayette, IN
• Providers in West Lafayette, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.