Martina Basta, DDS
Individual provider Active NPI General Practice Dentistry · Perris, CA
NPI 1578455259 · NPPES record last updated Jul 17, 2025
Key facts
- NPI
- 1578455259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 111613 (CA)
- Practice address
- 3150 Case Rd BLDG C
Perris, CA 92570-5552 - Phone
- (951) 345-4386
- NPI assigned
- Jul 17, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111613 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercer and Pham Dental Corporation | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 111613 | CA | Yes |
Addresses
Primary practice location
3150 Case Rd BLDG C
Perris, CA 92570-5552
Mailing address
3150 Case Rd BLDG C
Perris, CA 92570-5552
Phone (951) 345-4386
Other providers in Perris, CA
- Charolette A Barnes-Leblanc
- Randee Barraza
- Daniel Barrera
- Leslie Carolyn Barron-Topete
- Rachael Arlene Basquez
- Halbert Beaver
- Stacey Leeanne Beckman
- Veronica Denay Bejarano
- Masum Abdul Khabir Bennerson
- Russle Calvinist Benson
All providers in Perris, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.