Jessica Cervantes Martens, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

09001 Issued in IA

Practice address

1415 Broadway
Denison, IA 51442-2052

Phone

(712) 263-5615

Fax

(712) 263-8124

NPI assigned

Jun 26, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Broadway Dental LLC

  • General Practice Dentistry
  • Denison, IA
  • NPI 1790816817
  NPD (past)

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1629418488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 BROADWAY",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "514422052",
            "telephone_number": "712-263-5615",
            "fax_number": "712-263-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 BROADWAY",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "514422052",
            "telephone_number": "712-263-5615",
            "fax_number": "712-263-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTENS",
        "first_name": "JESSICA",
        "middle_name": "CERVANTES",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "09001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael P Luft, D.O.
• Patrick Luft
• Sara Nicole Luft, NP
• Sarah R Lundell
• Amber Nicole Mahrt, DNPC, MSN, RN
• Rose Mary Mason, MD
• Danette Miller, DPT
• John Miller
• Kelsey Miller, DDS
• MLG Physical Therapy PLLC

• General Practice Dentistry in Denison, IA
• Providers in Denison, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.