Individual provider Active NPI

Luz E Martinez

  • Dental Assistant
  • San Pedro, CA
National Provider Identifier
1447659776
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
RDA65179 Issued in CA
Practice address
973 W 7TH St Apt C
San Pedro
San Pedro, CA 90731-3075
Phone
(310) 808-7494
NPI assigned
Aug 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X RDA65179 CA Primary

Addresses

Primary practice location

973 W 7TH St Apt C
San Pedro
San Pedro, CA 90731-3075

Mailing address

973 W 7TH St Apt C
San Pedro
San Pedro, CA 90731-3075
Phone (310) 808-7494

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
RDA65179CAMDDental Assistant

NPI Registry JSON

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1447659776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "973 W 7TH ST APT C",
            "address_2": "SAN PEDRO",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313075",
            "telephone_number": "310-808-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "973 W 7TH ST APT C",
            "address_2": "SAN PEDRO",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313075",
            "telephone_number": "310-808-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "LUZ",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "RDA65179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.