Active NPI
Edmundo Martinez, DDS, MS
- Prosthodontics
- Greensboro, NC
National Provider Identifier
1558435537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 6414
- Practice address
- 1002 N Church St Ste 206
Greensboro, NC 27401-1448 - Phone
- (336) 378-9433
- Fax
- (336) 378-9796
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 6414 | NC | Primary |
Addresses
Primary practice location
1002 N Church St Ste 206
Greensboro, NC 27401-1448
Mailing address
4907 Setter CT
Jamestown, NC 27282-8655
Phone (336) 323-1499
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6414 | NC | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558435537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4907 SETTER CT",
"city": "JAMESTOWN",
"state": "NC",
"postal_code": "272828655",
"telephone_number": "336-323-1499",
"fax_number": "336-378-9796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 N CHURCH ST STE 206",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274011448",
"telephone_number": "336-378-9433",
"fax_number": "336-378-9796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "EDMUNDO",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NC",
"license": "6414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.