NPIMap

Organization Active NPI

Mercedes Mota-Martinez, Dentist, PC

  • General Practice Dentistry
  • Corona, NY
National Provider Identifier
1578697066
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
043710 Issued in NY
Legal business name
MERCEDES MOTA-MARTINEZ, DENTIST, PC
Practice address
10401 Roosevelt Ave
Corona, NY 11368-2327
Phone
(718) 779-2214
NPI assigned
Mar 15, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mercedes Mota-Martinez, DDSNPI 1073572996
Title
President
Phone
(718) 779-2214

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 040540 NY
General Practice Dentistry 1223G0001X 043710 NY Primary
General Practice Dentistry 1223G0001X 047641 NY

Addresses

Primary practice location

10401 Roosevelt Ave
Corona, NY 11368-2327

Mailing address

10401 Roosevelt Ave
Corona, NY 11368-2327
Phone (718) 779-2214

Other identifiers 3

IdentifierTypeStateIssuer
01268620MedicaidNY
01869956MedicaidNY
00998187MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578697066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682327",
            "telephone_number": "718-779-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682327",
            "telephone_number": "718-779-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCEDES MOTA-MARTINEZ, DENTIST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOTA-MARTINEZ",
        "authorized_official_first_name": "MERCEDES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-779-2214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040540",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043710",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047641",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01268620",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01869956",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00998187",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.