Individual provider Active NPI

Jon C Martinez, DDS

  • General Practice Dentistry
  • Overland Park, KS
National Provider Identifier
1629127147
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7066 Issued in KS
Practice address
7030 W 107TH St Ste 220
Overland Park, KS 66212-1898
Phone
(913) 642-4200
Fax
(913) 642-4260
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7066 KS Primary

Addresses

Primary practice location

7030 W 107TH St Ste 220
Overland Park, KS 66212-1898

Mailing address

7030 W 107TH St Ste 220
Overland Park, KS 66212-1898
Phone (913) 642-4200

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

State licenses

LicenseStateTypeSpecialty
7066KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jon C Martinez DDS Inc Past Accepting new patients

Organizations & group practices 1

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629127147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7030 W 107TH ST STE 220",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121898",
            "telephone_number": "913-642-4200",
            "fax_number": "913-642-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7030 W 107TH ST STE 220",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121898",
            "telephone_number": "913-642-4200",
            "fax_number": "913-642-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "7066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

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.

Verify at the official NPI Registry.