Individual provider Active NPI

Krystee Marie Martinez, CRDH

  • Dental Hygienist
  • New Smyrna, FL
National Provider Identifier
1740876853
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH26243 Issued in FL
Practice address
1119 S Dixie Fwy
New Smyrna, FL 32168-7473
Phone
(386) 428-3228
NPI assigned
Dec 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH26243 FL Primary

Addresses

Primary practice location

1119 S Dixie Fwy
New Smyrna, FL 32168-7473

Mailing address

3124 Needle Palm Dr
Edgewater, FL 32141-6221
Phone (386) 314-3294

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
DH26243FLMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. CurrentSince Jun 22, 2021 Accepting new patients
Coast Florida P.a. PastSince Dec 16, 2020 Accepting new patients

Locations

1119 S Dixie Fwy
New Smyrna Beach, FL 32168
Phone (386) 428-3228

Organizations & group practices 2

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": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1740876853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 NEEDLE PALM DR",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321416221",
            "telephone_number": "386-314-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 S DIXIE FWY",
            "city": "NEW SMYRNA",
            "state": "FL",
            "postal_code": "321687473",
            "telephone_number": "386-428-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KRYSTEE",
        "middle_name": "MARIE",
        "credential": "CRDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "FL",
            "license": "DH26243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.