Alexandro Martinez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.035287 Issued in IL

Practice address

1704 Patton Dr
Mahomet, IL 61853-8136

Phone

(217) 586-7878

NPI assigned

Jul 6, 2024

Last updated

Jul 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Henderson County Rural Health Center Inc

  dba Eagle View Community Health System

  • Federally Qualified Health Center (FQHC)
  • Stronghurst, IL
  • NPI 1972662658
  NPD (past)

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

{
    "created_epoch": "1720224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720224000000",
    "number": "1376389619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N MATTIS AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618211469",
            "telephone_number": "630-209-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 PATTON DR",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618538136",
            "telephone_number": "217-586-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ALEXANDRO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-06",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.035287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helena Diane Longfellow, APRN, FNP-C
• Karissa Marie Louthan, M.S., CCC-SLP
• Katherine Loutrel, M.D.
• Mahomet Clinic LLC
• Linah Kwamboka Mairura, M.D.
• Beth Mathews, APN
• Katherine Maxwell, OTR/L
• MBS Envision LLC
• MBS Envision, Inc
• Mariah L McAnally, LSW

• General Practice Dentistry in Mahomet, IL
• Providers in Mahomet, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.

Verify at the official NPI Registry.