Juan G. Martinez DDS, Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

JUAN G. MARTINEZ DDS, INC

Doing business as

Corona Smile Shoppe

Practice address

490 N Main St Ste 207
Corona, CA 92878-3461

Phone

(951) 444-7010

NPI assigned

Oct 19, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Juan Gerardo Martinez, DDSNPI 1003363243

Title

Director

Phone

(510) 697-1029

Specialties & licenses 1

Addresses

Other names 1

• Corona Smile Shoppe Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Juan Gerardo Martinez, DDS

  • General Practice Dentistry
  • Corona, CA
  • NPI 1003363243
  NPD Authorized official

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1750980140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 WILLOW RD",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 N MAIN ST STE 207",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928783461",
            "telephone_number": "951-444-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN G. MARTINEZ DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "GERARDO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "510-697-1029",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corona Smile Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Corona, CA
• Providers in Corona, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.