Individual provider Active NPI

Eileen Marie Martinez, DDS, MS

  • Pediatric Dentistry
  • Chillicothe, OH
National Provider Identifier
1619136157
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30-022970 Issued in OH
Practice address
1140 Western Ave
Chillicothe, OH 45601
Phone
(740) 773-8320
NPI assigned
Jun 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 30-022970 OH Primary

Addresses

Primary practice location

1140 Western Ave
Chillicothe, OH 45601

Mailing address

3000 Arlington Ave
Toledo, OH 43614-2595
Phone (419) 383-3504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160810000747 OH Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 0446571806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
30-022970OHMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald a. Griffin, DDS, LLC Pediatric Dentistry Past Accepting new patients
Musial-Gill Properties LLC PastSince Sep 13, 2020 Accepting new patients
Ocean Dental of Ohio, P.C. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1619136157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595",
            "telephone_number": "419-383-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 WESTERN AVE",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "45601",
            "telephone_number": "740-773-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "EILEEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30-022970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.