Individual provider Active NPI

Andres K Martinez

  • Pediatric Dentistry
  • Los Angeles, CA
National Provider Identifier
1770899304
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
59245 Issued in CA
Practice address
1111 W 6TH St
#120
Los Angeles, CA 90017-1823
Phone
(213) 895-0009
Fax
(213) 895-0012
NPI assigned
Aug 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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 59245 CA Primary

Addresses

Primary practice location

1111 W 6TH St
#120
Los Angeles, CA 90017-1823

Mailing address

1680 E Hill St
3Rd FL
Signal Hill, CA 90755-3612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150915001864 CA Order and Referring Only - DentistPractitioner - Dentist 7517274137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Loo, Hsiao, & Tsai, a Professional Corporation Past Accepting new patients
Tsai, Hslao & Loo Dental Corporation Past Accepting new patients

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": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1770899304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 E HILL ST",
            "address_2": "3RD FL",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907553612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W 6TH ST",
            "address_2": "#120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171823",
            "telephone_number": "213-895-0009",
            "fax_number": "213-895-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ANDRES",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "59245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.