Individual provider Active NPI

Juan Jose Martinez, DDS

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1396184156
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29075 Issued in TX
Practice address
2811 Airline Dr Ste 1
Houston, TX 77009-1151
Phone
(832) 834-4200
NPI assigned
Jun 14, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 29075 TX Primary

Addresses

Primary practice location

2811 Airline Dr Ste 1
Houston, TX 77009-1151

Mailing address

2811 Airline Dr
Ste 1
Houston, TX 77009-1151
Phone (832) 834-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231227002357 TX Order and Referring Only - DentistPractitioner - Dentist 8022307776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29075TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Juan J. Martinez DDS, PLLC General Practice CurrentSince Jun 30, 2024 Accepting new patients

Locations

2811 Airline Dr
Ste 1
Houston, TX 77009
Phone (832) 274-0167

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1396184156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 AIRLINE DR",
            "address_2": "STE 1",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770091151",
            "telephone_number": "832-834-4200",
            "fax_number": "832-201-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 AIRLINE DR STE 1",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770091151",
            "telephone_number": "832-834-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JUAN",
        "middle_name": "JOSE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-14",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.