Ivan Medina-Martinez DDS, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

102012 Issued in CA

Legal business name

IVAN MEDINA-MARTINEZ DDS, INC.

Practice address

2122 Brundage LN
Bakersfield, CA 93304-2702

Phone

(661) 437-6877

Fax

(661) 349-9980

NPI assigned

Jun 7, 2018

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ivan Alejandro Medina-Martinez, DDSNPI 1114436854

Title

President

Phone

(661) 437-6877

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ivan Alejandro Medina-Martinez, DDS

  • Dentist
  • Bakersfield, CA
  • NPI 1114436854
  NPD Authorized official

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1467945212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 WILSON RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933095208",
            "telephone_number": "661-489-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 BRUNDAGE LN",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933042702",
            "telephone_number": "661-437-6877",
            "fax_number": "661-349-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVAN MEDINA-MARTINEZ DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-07",
        "last_updated": "2023-03-07",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "MEDINA-MARTINEZ",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "ALEJANDRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-437-6877",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "102012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1114436854",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DENTAL BOARD",
            "identifier": "102012",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Issa, MD
• Aji Issac
• Hiroki Ito, M.D.
• Yukiko Ito, PA-C
• Mariana Nicole Iturry Rojas
• Janine Ivy, MFT
• Nelson Toshio Iwata, O.D.
• Joy Nneka Iwuchukwu, DNP, MSN, APRN-BC
• Kamalnath Iyer, M.D.
• J Chandrasekhar Inc

• Dental Clinic/Center in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.